FEC Form 1 for UNITED FOOD & COMMERCIAL WORKERS ACTIVE BALLOT CLUBForm 1 for UNITED FOOD & COMMERCIAL WORKERS ACTIVE BALLOT CLUB

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-111438

1. UNITED FOOD & COMMERCIAL WORKERS ACTIVE BALLOT CLUB

1775 K STREET N.W.
WASHINGTON, DC 20006

NOTE: Address is different than previously reported

2. Date: 03/03/2004

3. FEC Committee ID #: C00002766 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

United Food & Commercial Workers International Union
1775 K St N.W.
Washington, DC 200061598
Relationship: Connected Organizat.
Organization Type: Labor Organization

Custodian of Records:

ANTHONY PERRONE
1775 K STREET N.W.
WASHINGTON, DC 200061598
Title: Secretary-Treasurer
Phone # (202) 223-3111

Treasurer:

ANTHONY PERRONE
1775 K STREET N.W.
WASHINGTON, DC 200061598
Title: Secretary-Treasurer
Phone # (202) 223-3111

Designated Agent(s):

Banks or Depositories

SUNTRUST BANK
900 17th Street N.W.
Washington, DC 20006

Signed: ANTHONY PERRONE
Date Signed: 03/12/2004

(End FEC FORM 1)

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