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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1184904

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1. Theobald For Congress

    85718 544 Avenue
    Osmond, NE 68765
    Email: ptheobald36@gmail.com

2. Date: 10/10/2017

3. FEC Committee ID #: C00657718 This committee is a Principal Campaign Committee. Candidate: Paul Theobald
Party: Democratic Party
Office Sought: House of Representatives
State is Nebraska in District: 03

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Maureen Theobald
85718 544 Avenue
Osmond, NE 68765
Phone # (402) 369-3818

Treasurer:

Maureen Theobald
85718 544 Avenue
Osmond, Nebraska 68765
Phone # (402) 369-3818

Designated Agent(s):

Jim Curtiss
1011 Lincoln Street
Wayne, Nebraska 68787
Phone # (402) 369-2188

Banks or Depositories

Midwest bank
P. O. Box 219
Pierce, Nebraska 68767

Signed: Maureen Theobald
Date Signed: 10/10/2017

(End FEC FORM 1)

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