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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-709260

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1. Thomas Petri

N5329 Deneveu Lane
Fond Du Lac, WI 549379669

2. Identification Number: H0WI06061

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Wisconsin - 6

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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 2012 election(s).

    Citizens for Tom Petri
    FEC ID #: C00107003

    PO Box 270
    Fond Du Lac, WI 549360270

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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.

   

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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: Thomas Petri
Signed by the candidate on: 01/28/2011

Filed: 01/28/2011

(End FEC FORM 2)

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