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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1177003

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1. TEAM HOLCOMB

    101 W. OHIO STREET
    SUITE 2200
    INDIANAPOLIS, IN 46204
    Email: derekhugo@holcombforindiana.com;tsmith@indiana.gop

2. Date: 07/31/2017

3. FEC Committee ID #: C00647149

This committee is a political committee with both contribution and non-contribution accounts (Hybrid PAC).

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Derek Hugo
2616 Belize Dr
Evansville, IN 47725
Title: Treasurer
Phone # (317) 569-0709

Treasurer:

Derek Hugo
2616 Belize Dr
Evansville, Indiana 47725
Title: Treasurer
Phone # (317) 569-0709

Designated Agent(s):

Tracy Smith
2631 Willow Lake Dr
Greenwood, Indiana 46143
Title: Controller
Phone # (317) 635-7561

Banks or Depositories

Old National Bank
101 W Ohio St
Indianapolis, Indiana 46204

Signed: Derek Hugo
Date Signed: 07/31/2017

(End FEC FORM 1)

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