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1 Image# FE FORM 1 STATEMENT OF ORGANIZATION (See instructions) Office use only 12/10/ : 30 1 NAME OF (heck if name Example: If typying, type OMMITTEE (in full) is changed) over the lines 12FE4M5 America's New Majority X ADDRESS (number and street) (heck if address is changed) 228 S Washington Street Suite 115 Alexandria VA ITY STATE ZIP ODE OMMITTEE'S ADDRESS (Please provide only one address) (heck if address kdavis@hdafeccom X is changed) OMMITTEE'S WEB PAGE ADDRESS (URL) (heck if address is changed) 2 M M / D D / DATE D Y Y Y Y 3 FE IDENTIFIATION NUMBER IS THIS STATEMENT X NEW (N) OR AMENDED (A) I certify that I have examined this Statement and to the best of my knowledge and belief it is true, correct and complete Type or Print Name of Treasurer Keith A Davis Signature of Treasurer Electronically Filed by M M / D D / Y Y Y Y Keith A Davis Date NOTE: Submission of false, erroneous, or incomplete information may subject the person signing this Statement to the penalties of 2 US 437g ANY HANGE IN INFORMATION SHOULD BE REPORTED WITHIN 10 DAYS Office Use Only For further information contact: Federal Election ommission Toll Free (Revised 02/2009) Local FE FORM 1
2 Image# FE Form 1 (Revised 02/2009) Page 2 5 TYPE OF OMMITTEE (heck One) andidate ommittee: (a) This committee is a principal campaign committee (omplete the candidate information below) (b) This committee is an authorized committee, and is NOT a principal campaign committee (omplete the candidate information below) Name of andidate andidate Party Affiliation Office Sought: House Senate President State District (c) This committee supports/opposes only one candidate, and is NOT an authorized committee Name of andidate Party ommittee: (National, State (Democratic, (d) This committee is a (or subordinate) committee of the Republican,etc) Party Political Action ommittee (PA): (e) This committee is a separate segregated fund (Identify connected organization on line 6) Its connected organization is a: orporation Membership Organization orporation w/o apital Stock Trade Association Labor Organization ooperative (f) In addition, this committee is a Lobbyist/Registrant PA This committee supports/opposes more than one Federal candidate, and is NOT a separate segregated fund or party committee (ie, nonconnected committee) Joint Fundraising Representative: In addition, this committee is a Lobbyist/Registrant PA In addition, this committee is a Leadership PA (Identify sponsor on line 6) (g) (h) X This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political committees/organizations, at least one of which is an authorized committee of a federal candidate This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political committees/organizations, none of which is an authorized committee of a federal candidate ommittees Participating in Joint Fundraiser 1 DENHAM FOR ONGRESS FE ID number FRIENDS OF SOTT DESJARLAIS 2 FE ID number DOLD FOR ONGRESS FE ID number RENEE ELLMERS FOR ONGRESS OMMITTEE FE ID number
3 Image# FE Form 1 (Revised 02/2009) Page 3 Write or Type ommittee Name America's New Majority 6 Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor NONE ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor 7 ustodian of Records: Identify by name, address, (phone number -- optional), and position of the person in possession of ommittee books and records Keith A Davis 228 S Washington Street Suite 115 Alexandria VA Title or Position ITY STATE ZIP ODE Treasurer Treasurer: List the name and address (phone number -- optional) of the treasurer of the committee; and the name and address of any designated agent (eg, assistant treasurer) of Treasurer Keith A Davis 228 S Washington Street Suite 115 Alexandria VA Title or Position ITY STATE ZIP ODE Treasurer
4 Image# FE Form 1 (Revised 02/2009) Page 4 of Designated Agent Lisa R Lisker 228 S Washington Street Suite 115 Alexandria VA Title or Position ITY STATE ZIP ODE Assistant Treasurer safety deposit boxes or maintains funds BB&T 1909 K Street NW Washington D ITY STATE ZIP ODE ITY STATE ZIP ODE
5 Image# FE Form 1 (Revised 02/2009) Page 5 safety deposit boxes or maintains funds ITY STATE ZIP ODE Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor Title or Position ITY STATE ZIP ODE LANDRY FOR LOUISIANA FE ID number
6 Image# FE Form 1 (Revised 02/2009) Page 6 safety deposit boxes or maintains funds ITY STATE ZIP ODE Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor Title or Position ITY STATE ZIP ODE MARINO FOR ONGRESS FE ID number
7 Image# FE Form 1 (Revised 02/2009) Page 7 safety deposit boxes or maintains funds ITY STATE ZIP ODE Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor Title or Position ITY STATE ZIP ODE TOM REED FOR ONGRESS FE ID number
8 Image# FE Form 1 (Revised 02/2009) Page 8 safety deposit boxes or maintains funds ITY STATE ZIP ODE Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor Title or Position ITY STATE ZIP ODE DAVID RIVERA FOR ONGRESS FE ID number
9 Image# FE Form 1 (Revised 02/2009) Page 9 safety deposit boxes or maintains funds ITY STATE ZIP ODE Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor Title or Position ITY STATE ZIP ODE JON RUNYAN FOR ONGRESS, IN FE ID number
10 Image# FE Form 1 (Revised 02/2009) Page 10 safety deposit boxes or maintains funds ITY STATE ZIP ODE Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor Title or Position ITY STATE ZIP ODE SOUTHERLAND FOR ONGRESS FE ID number
11 Image# FE Form 1 (Revised 02/2009) Page 11 safety deposit boxes or maintains funds ITY STATE ZIP ODE Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor Title or Position ITY STATE ZIP ODE STUTZMAN FOR ONGRESS FE ID number
12 Image# FE Form 1 (Revised 02/2009) Page 12 safety deposit boxes or maintains funds ITY STATE ZIP ODE Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor Title or Position ITY STATE ZIP ODE YODER FOR ONGRESS FE ID number
13 Image# FE Form 1 (Revised 02/2009) Page 13 safety deposit boxes or maintains funds ITY STATE ZIP ODE Name of Any onnected Organization, Affiliated ommittee, Joint Fundraising Representative, or Leadership PA Sponsor ITY STATE ZIP ODE onnected Organization Affiliated ommittee Joint Fundraising Representative Leadership PA Sponsor Title or Position ITY STATE ZIP ODE JEFF PA FE ID number
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Image# 201703139050767680 FE FORM 1 1. NAME OF OMMITTEE (in full) MENT OF ORGANIZATION (heck if name Montana Democratic Party Example: If typing, type over the lines. 12FE4M5 Office Use Only 03/13/2017
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FORM 1 STATEMENT OF ORGANZATON RECEVED MW CEHTER Office Use Onl^ 1. NAME OF COMfVTTEE (in full) (Check if name is changed) over ine lines. lw»>araassiwib^!wmwa^^^ Pawlenty for President Exploratory Committee!
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