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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-809478

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1. Suzan K DelBene

PO Box 487
Bothell, WA 98041

2. Identification Number: H0WA08046

3. Party: Democratic Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Washington - 1

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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).

    DelBene for Congress
    FEC ID #: C00459099

    PO Box 487
    Bothell, WA 98041

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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.

    DelBene Victory 2012
    FEC ID #: C00528604

    603 Stewart St #819
    Seattle, WA 98101

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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: Suzan K DelBene
Signed by the candidate on: 09/13/2012

Filed: 09/13/2012

(End FEC FORM 2)

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