OKLAHOMA ETHICS COMMISSION PHONE: (405) 521-3451 ‡ FAX: (405) 521-4905 ‡ WEBSITE: WWW.OK.GOV/ETHICS STATEMENT OF ORGANIZATION CANDIDATE COMMITTEE 1.CANDIDATE INFORMATION AMENDED FORM: Name as it will appear on the ballot(Last, First, Middle) Party Affiliation FU, BEN REPUBLICAN Complete Name of Office Sought Special or General Election Date DISTRICT ATTORNEY, DISTRICT 14 11/6/2018 Candidate Residence Street Address 1 Candidate Mailing Address 1 1555 S 78TH EAST AVE 1555 S 78TH EAST AVE Candidate Residence Street Address 2 Candidate Mailing Address 2 Candidate Residence City, State, Zip Code Candidate Mailing City, State, Zip Code TULSA, OK 74112 TULSA, OK 74112 Phone Number 1 (xxx) xxx-xxxx Ext.xxxxx Phone Number 2 (xxx) xxx-xxxx Ext.xxxxx Yes Candidate Email Address (405) 760-0263 BENFU@SWABSTALL.COM 2. COMMITTEE INFORMATION Candidate Committee Name: CITIZENS FOR BEN FU 2018 Committee Physical Street Address 1 Committee Mailing Address 1 2021 S LEWIS AVE 2021 S LEWIS AVE Committee Physical Street Address 2 Committee Mailing Address 2 SUITE 520 SUITE 520 Committee Physical City, State, Zip Code Committee Mailing City, state, Zip code TULSA, OK 74104 TULSA, OK 74104 Phone Number 1 (xxx)xxx-xxxx Ext. xxxxx Phone Number 2(xxx)xxx-xxxx Ext. xxxxx Committee Email address (918) 607-4598 INFO@ELECTBENFU.COM Committee website Address Social Media Account Address Social Media Account Address Social Media Account Address Social Media Account Address HTTP://WWW.ELECTBENFU.COM Social Media Account Address 3.COMMITTEE OFFICERS' INFORMATION Chair Name (First, Middle, Last) Treasurer Name (First, Middle, Last) Deputy Treasurer Name (First, Middle, Last) THEODORE BRETT SWAB JESSICA FU BEN FU Address 1 Address 1 2021 S LEWIS AVENUE Address 1 1555 S 78TH EAST AVE Address 2 1555 S 78TH EAST AVE Address 2 Address 2 SUITE 335 City, State, Zip Code City, State, Zip Code City, State, Zip Code TULSA, OK 74104 TULSA, OK 74112 TULSA, OK 74112 Phone Number (xxx) xxx-xxxx ext. xxxxx Phone Number (xxx) xxx-xxxx ext. xxxxx Phone Number (xxx) xxx-xxxx ext. xxxxx (918) 814-5200 (405) 642-5594 (405) 760-0263 Email address Email address Email address TBSWAB@SWABSTALL.COM SIGFU22@YAHOO.COM BENFU@SWABSTALL.COM 4. DEPOSITORY INFORMATION Account 1 Account 2 Account 3 Account 4 Address 1 Address 1 Address 1 Address 2 Address 2 Address 2 Address 2 City, State, Zip code City, State, Zip code City, State, Zip code City, State, Zip code BANK OF OKLAHOMA Address 1 2021 S LEWIS AVENUE TULSA,OK 74104 By signing, electronic or otherwise, my name below, I, the Candidate identified on this form, acknowledge that the information submitted is complete, true and accurate, as of the date submitted below. I understand the failure to provide such information is a violation of the Ethics Rules of Oklahoma. I understand that I can update the information above at any time by filing an amended statement of organization. 5/2/2018 FU, BEN Date Submitted Filing Date: 5/2/2018 12:08 AM Candidate Signature Printing Date: 5/2/2018 2:11:27 PM Page 1 of 1