FEC Form 1 for Ben Bullock for Congress Inc.Form 1 for Ben Bullock for Congress Inc.

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1376167

1. Ben Bullock for Congress Inc.

33 Courthouse Square
Dallas, GA 30132

NOTE: Address is different than previously reported

Email: kdavis@hdafec.com;tmoose@hdafec.com

2. Date: 01/30/2020

3. FEC Committee ID #: C00705327 This committee is a Principal Campaign Committee. Candidate: Benjamin E. Bullock
Party: Republican Party
Office Sought: House of Representatives
State is Georgia in District: 14

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Taylor K. Moose
228 S. Washington Street
Suite 115
Alexandria, VA 22314
Title: Accountant
Phone # (703) 549-7705

Treasurer:

Keith A. Davis
228 S. Washington Street
Suite 115
Alexandria, Virginia 22314
Title: Treasurer
Phone # (703) 549-7705

Designated Agent(s):

Lisa R. Lisker
228 S. Washington Street
Suite 115
Alexandria, Virginia 22314
Title: Assistant Treasurer
Phone # (703) 549-7705

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1376167

1. Ben Bullock for Congress Inc.

NOTE: Address is different than previously reported

2. Date: 01/30/2020

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Keith A. Davis
Date Signed: 01/30/2020

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1376167

1. Ben Bullock for Congress Inc.

NOTE: Address is different than previously reported

2. Date: 01/30/2020

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Keith A. Davis Date Signed: 01/30/2020

(End FEC FORM 1)

Signed: Keith A. Davis
Date Signed: 01/30/2020