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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1055242

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1. Derickson K for Congress

    PO Box 243
    Bronxville, NY 10708
    Email: dericksonkforcongress@yahoo.com;dkl@marketvw.com

2. Date: 03/04/2016

3. FEC Committee ID #: C00611905 This committee is a Principal Campaign Committee. Candidate: Derickson K Lawrence
Party: Democratic Party
Office Sought: House of Representatives
State is New York in District: 16

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Derickson K Lawrence
149 Esplanade
Mount Vernon, NY 10553
Title: Candidate
Phone # (914) 548-0405

Treasurer:

Matthew Schiebler
PO Box 767;
63 Adams Ave
Bedford Hills, New York 10507
Title: Treasurer
Phone # (914) 263-9806

Designated Agent(s):

Banks or Depositories

Wells Fargo Bank
PO Box 6995
Portland, Oregon 97228

Signed: Matthew Schiebler
Date Signed: 03/14/2016
Official Committee URL: www.dericksonkforcongress.com

(End FEC FORM 1)

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