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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-1355165

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1. Andrew James Jacobs Jr.

1201 W. 64th Street
Indianapolis, IN 46260

2. Identification Number: H0IN05227

3. Party: Democratic Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Indiana - 5

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DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE

7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2020 election(s).

    COMMITTEE TO ELECT ANDY JACOBS
    FEC ID #: C00714147

    1201 W 64TH STREET
    INDIANAPOLIS, IN 46260

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DESIGNATION OF OTHER AUTHORIZED COMMITTEES

8. I hereby designate the following named committee, which is NOT my principal campaign committee, to receive and expend funds on behalf of my candidacy.

   

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DECLARATION OF INTENT TO EXPEND PERSONAL FUNDS (House or Senate Only)

9. I intend to expend personal funds exceeding the threshold amount (see 11 C.F.R. 400.9) by

    9A. 0.00 for the primary election, and
    9B. 0.00 for the general election

Signed as: Andrew James Jacobs Jr.
Signed by the candidate on: 10/08/2019

Filed: 10/08/2019

(End FEC FORM 2)

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