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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1663726

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1. Mary Miller for Congress

    3710 Broadway Street
    Box 102
    Quincy, IL 62305

    NOTE: Address is different than previously reported

    Email: marymiller@rtastrategy.com;bendemarzo@gmail.com

2. Date: 11/09/2022

3. FEC Committee ID #: C00723916 This committee is a Principal Campaign Committee. Candidate: Mary Miller
Party: Republican Party
Office Sought: House of Representatives
State is Illinois in District: 15

Affiliated Committees/Organizations

Candidate ID# H0IL15129
MARY MILLER
23326 E COUNTY ROAD 1960 N
OAKLAND, Illinois 61943
Affiliated Relationship Code: Leadership PAC Sponsor

Committee ID# C00809921
MARY MILLER VICTORY COMMITTEE
23326 E COUNTY ROAD 1960 N
OAKLAND, Illinois 61943
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

JASON D BOLES
PO BOX 1483
ROSWELL, GA 30077
Title: TREASURER
Phone # (404) 474-7226

Treasurer:

JASON D BOLES
PO BOX 1483
ROSWELL, Georgia 30077
Title: TREASURER
Phone # (404) 474-7226

Designated Agent(s):

Derek Ross
300 Independence Avenue SE
Washington, DC 20003
Title: Attorney In Fact

Rick Thompson
PO Box 1483
Roswell, Georgia 30077
Title: Assistant Treasurer

Banks or Depositories

Middletown Valley Bank
24 W Main Street
Middletown, Connecticut 21740

ServisFirst Bank
300 Galleria Parkway SE
Atlanta, Georgia 30339

Signed: JASON D BOLES
Date Signed: 12/02/2022
Official Committee URL: www.marymillerforcongress.com

(End FEC FORM 1)

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