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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1155645

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1. Sarah Lloyd for Congress

    W13615 Nelson Rd
    Wisconsin Dells, WI 53965

    NOTE: Address is different than previously reported

    Email: sarahlloyd53965@gmail.com;mwdavis02@centurytel.net

    NOTE: Email address is different than previously reported

2. Date: 04/09/2017

3. FEC Committee ID #: C00611525 This committee is a Principal Campaign Committee. Candidate: Sarah Lloyd
Party: Democratic Party
Office Sought: House of Representatives
State is Wisconsin in District: 06

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Mark Wayne Davis
W6593 Drake Rd
Rio, WI 53960
Title: Treasurer
Phone # (920) 350-8186

Treasurer:

Mark Wayne Davis
W6593 Drake Rd
Rio, Wisconsin 53960
Title: Treasurer
Phone # (920) 350-8186

Designated Agent(s):

Mark Wayne Davis
W6593 Drake Rd
Rio, Wisconsin 53960
Title: Treasurer
Phone # (920) 350-8186

Banks or Depositories

Associated Bank
102 N Main St
Lodi, Wisconsin 53555

Signed: Mark Wayne Davis
Date Signed: 04/09/2017

(End FEC FORM 1)

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