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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1151785

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1. PAUL GOSAR FOR CONGRESS

    PO Box 2967
    Prescott, AZ 86302
    Email: brian@drpowley.com

2. Date: 03/09/2017

3. FEC Committee ID #: C00461806 This committee is a Principal Campaign Committee. Candidate: Dr. Paul Gosar
Party: Republican Party
Office Sought: House of Representatives
State is Arizona in District: 04

Affiliated Committees/Organizations

Committee ID# C00573550
FreedomWorks PAC
PO Box 75760
Washington, DC 20013
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

William Brian Powley
10565 N Tatum Blvd., B111
Paradise Valley, AZ 85253
Title: Record Keeper
Phone # (480) 220-5464

Treasurer:

William Brian Powley
10565 N Tatum Blvd., B111
Paradise Valley, Arizona 85253
Title: Treasurer
Phone # (480) 220-5464

Designated Agent(s):

Banks or Depositories

Wells Fargo Bank
10959 E Dynamite Blvd.
Scottsdale, Arizona 85262

Suntrust Bank
PO Box 4418
Atlanta, Georgia 30302

Signed: William Brian Powley
Date Signed: 03/09/2017
Official Committee URL: www.gosarforcongress.com

(End FEC FORM 1)

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