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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1185199

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1. Jeremy Kelly

    46 Putter Dr.
    Palm Coast, FL 32164
    Email: Jeremy.kelly3@outlook.com;IV_leaf@outlook.com

2. Date: 10/11/2017

3. FEC Committee ID #: C00657809 This committee is a Principal Campaign Committee. Candidate: Jeremy J Kelly
Party: Republican Party
Office Sought: House of Representatives
State is Florida in District: 06

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Brittany Kelly
46 Putter Dr.
Palm Coast, FL 32164
Phone # (321) 693-1320

Treasurer:

Brittany Kelly
46 Putter Dr.
Palm Coast, Florida 32164
Phone # (321) 693-1320

Designated Agent(s):

Banks or Depositories

Bank Of America
4850 Belle Terre Pkwy
Palm Coast, Florida 32164

Signed: Brittany Kelly
Date Signed: 10/11/2017

(End FEC FORM 1)

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