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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-1620381

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1. Lori Chavez-DeRemer

11805 SE Eastbourne Lane
Happy Valley, OR 97086

2. Identification Number: H2OR05209

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Oregon - 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 2022 election(s).

    Lori Chavez-DeRemer for Congress
    FEC ID #: C00784520

    11805 SE Eastbourne Lane
    Happy Valley, OR 97086

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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.

    CHAVEZ-DEREMER SKARLATOS VICTORY 2022
    FEC ID #: C00802348

    PO BOX 23696
    TIGARD, OR 97281

    TAKE BACK OR-05 REPUBLICAN NOMINEE FUND 2022
    FEC ID #: C00775767

    PO BOX 30844
    BETHESDA, MD 20824

    LORI CHAVEZ-DEREMER VICTORY
    FEC ID #: C00819227

    PO BOX 23696
    TIGARD, OR 97281

    JERRY CARL CANDIDATE FUND
    FEC ID #: C00821678

    PO BOX 852138
    MOBILE, AL 36685

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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: Lori Chavez-DeRemer
Signed by the candidate on: 07/29/2022

Filed: 07/29/2022

(End FEC FORM 2)

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