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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1365856

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1. Burgess Victory Fund

    PO Box 30844
    Bethesda, MD 20824
    Email: info@campaignfinancial.com

2. Date: 12/10/2019

3. FEC Committee ID #: C00730549

This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political
committees/organizations, at least one of which is an authorized committee of a federal candidate.

Committees Participating in Joint Fundraiser

1. MICHAEL BURGESS FOR CONGRESS      FEC ID number C00372532
2. LONE STAR LEADERSHIP PAC      FEC ID number C00415208
3. NRCC      FEC ID number C00075820

Affiliated Committees/Organizations

NONE
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Custodian of Records:

Financial Services Campaign
PO Box 30844
Bethesda, MD 20824
Title: Custodian of Records
Phone # (301) 654-3220

Treasurer:

Steven Martin
PO Box 30844
Bethesda, Maryland 20824
Title: Treasurer
Phone # (301) 654-3220

Designated Agent(s):

Banks or Depositories

Wells Fargo
8302 Woodmont Avenue
Bethesda, Maryland 20814

Signed: Steven Martin
Date Signed: 12/10/2019

(End FEC FORM 1)

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