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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1088280

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1. Don Stapley for Congress

    P.O. Box 31724
    Mesa, AZ 85275
    Email: george@dataorbital.com

2. Date: 04/05/2016

3. FEC Committee ID #: C00613869 This committee is a Principal Campaign Committee. Candidate: Donald T Stapley
Party: Republican Party
Office Sought: House of Representatives
State is Arizona in District: 05

Affiliated Committees/Organizations

Committee ID# C00621599
STATE SEN. BOB WORSLEY, DON STAPLEY AND FRIENDS FUNDRAISING COMMITTEE
63 E. MAIN ST.
SUITE 102
MESA, Arizona 85201
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Jeffrey B. Pickles
3102 E. Hale
Mesa, AZ 85213
Title: Treasurer
Phone # (480) 284-3020

Treasurer:

Jeffrey B. Pickles
3102 E. Hale
Mesa, Arizona 85213
Title: Treasurer
Phone # (480) 284-3020

Designated Agent(s):

Jeffrey B. Pickles
3102 E. Hale
Mesa, Arizona 85213
Title: Treasurer
Phone # (480) 284-3020

Banks or Depositories

Wells Fargo Bank, N.A.
1333 South Alma School Road
Mesa, Arizona 85210

Signed: Jeffrey B. Pickles
Date Signed: 07/19/2016

FORM TEXT-1

(End FEC FORM 1)

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