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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1095565

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1. Nelson Victory Fund

    PO Box 348
    Kaukauna, WI 54130
    Email: vwinpisinger@gmail.com

2. Date: 08/19/2016

3. FEC Committee ID #: C00624288

This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political
committees/organizations, at least one of which is an authorized committee of a federal candidate.

Committees Participating in Joint Fundraiser

1. NELSON FOR WISCONSIN      FEC ID number C00614115
2. DEMOCRATIC PARTY OF WISCONSIN      FEC ID number C00019331

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Vickie Winpisinger
PO Box 83142
Gaithersburg, MD 20883
Title: Deputy Treasurer
Phone # 301947278

Treasurer:

Dr. Beth Gillis
N5740 Wolf River Court
Shawano, Wisconsin 54166
Title: Treasurer
Phone # (715) 526-2400

Designated Agent(s):

Vickie Winpisinger
PO Box 83142
Gaithersburg, Maryland 20883
Title: Deputy Treasurer
Phone # (301) 947-0278

Banks or Depositories

Bank of Kaukauna
264 Wisconsin Avenue
Kaukauna, Wisconsin 54130

Signed: Dr. Beth Gillis
Date Signed: 08/19/2016

(End FEC FORM 1)

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