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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-1557860

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1. Max Rose

1015 Castleton Ave
PO Box 359
Staten Island, NY 10310

2. Identification Number: H2NY11140

3. Party: Democratic Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: New York - 11

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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).

    Max Rose for Congress
    FEC ID #: C00796540

    1015 Castleton Ave
    PO Box 359
    Staten Island, NY 10310

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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.

    Rose Slotkin Victory Fund
    FEC ID #: C00801589

    PO Box 65322
    Washington, DC 20035

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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: Max Rose
Signed by the candidate on: 01/20/2022

Filed: 01/20/2022

(End FEC FORM 2)

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