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FEC Form 2 for Report FEC-710105FEC Form 2 for Report FEC-710105

FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-710105


1. Theodore Edward Rokita

7643 East U.S. 36
Avon, IN 461236123

2. Identification Number: H0IN04170

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Indiana - 4


DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE

7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2012 election(s).

    Hoosiers for Rokita Inc.
    FEC ID #: C00476192

    7643 East U.S. 36
    Avon, IN 461236123


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.

   


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: Theodore Edward Rokita
Signed by the candidate on: 01/30/2011

Filed: 01/30/2011

(End FEC FORM 2)


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