FEC Form 1 for Adrian Smith for CongressForm 1 for Adrian Smith for Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-983131

1. Adrian Smith for Congress

3321 Avenue I
Suite 6
Scottsbluff, NE 693614587
Email: committee@joinadrian.com

2. Date: 01/12/2015

3. FEC Committee ID #: C00412890 This committee is a Principal Campaign Committee. Candidate: Adrian Smith
Party: Republican Party
Office Sought: House of Representatives
State is Nebraska in District: 03

Affiliated Committees/Organizations

Committee ID# C00543314
Nebraska Joint Victory Fund
228 S Washington Street
Suite 115
Alexandria, Virginia 223145404
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Mrs. Lenora S Gompert
PO Box 46
Morrill, NE 693580046
Title: Treasurer

Treasurer:

Mrs. Lenora S Gompert
PO Box 46
Morrill, Nebraska 693580046
Title: Treasurer

Designated Agent(s):

Banks or Depositories

Platte Valley Bank
1212 Circle Drive
Scottsbluff, Nebraska 693612790

BB&T
1909 K Street NW
Washington, DC 200061152

Signed: Mrs. Lenora S Gompert
Date Signed: 01/12/2015

(End FEC FORM 1)

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