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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1097063

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1. Lake County Republican Party

    PO Box 1160
    Tavares, FL 32778
    Email: treasurer@lakecountyrepublicans.org;info@lakecountyrepublicans.org

    NOTE: Email address is different than previously reported

2. Date: 08/11/2016

3. FEC Committee ID #: C00623710 This committee is a Local committee of the Republican Party Party.

Affiliated Committees/Organizations

Committee ID# C00099259
REPUBLICAN PARTY OF FLORIDA
420 E. JEFFERSON STREET
TALLAHASSEE, Florida 32301
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Walter Price
1402 Cove Pl
Tavares, FL 32778
Title: Chairman
Phone # (352) 408-6479

Treasurer:

Andy Dubois
22011 Breezy Oak Drive
Howey in the Hills, Florida 34737
Title: Treasurer
Phone # (352) 874-5084

Designated Agent(s):

Banks or Depositories

United Southern Bank
2701 S. Bay St.
Eustis, Florida 32726

Signed: Andy Dubois
Date Signed: 08/26/2016
Official Committee URL: lakecountyrepublicans.org

FORM TEXT-1

(End FEC FORM 1)

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