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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-1605127

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1. BURGESS OWENS

PO BOX 49
RIVERTON, UT 84065

2. Identification Number: H0UT04076

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Utah - 4

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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 2022 election(s).

    BURGESS 4 UTAH
    FEC ID #: C00725853

    370 EAST SOUTH TEMPLE STE 580
    SALT LAKE CITY, UT 84111

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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.

    TAKE BACK THE HOUSE 2022
    FEC ID #: C00766782

    PO BOX 30844
    BETHESDA, MD 208240844

    BURGESS OWENS VICTORY COMMITTEE
    FEC ID #: C00786061

    824 S MILLEDGE AVE STE 101
    ATHENS, GA 30605

    JUST WIN BABY VICTORY FUND
    FEC ID #: C00819011

    824 S MILLEDGE AVE STE 101
    ATHENS, GA 30605

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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: BURGESS OWENS
Signed by the candidate on: 06/23/2022

Filed: 06/23/2022

(End FEC FORM 2)

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