FEC Form 1 for UNITED MINE WORKERS OF AMERICA - COAL MINERS POLITICAL ACTION COMMITTEEForm 1 for UNITED MINE WORKERS OF AMERICA - COAL MINERS POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-454793

1. UNITED MINE WORKERS OF AMERICA - COAL MINERS POLITICAL ACTION COMMITTEE

18354 QUANTICO GATEWAY DR
SUITE 200
TRIANGLE, VA 22172

NOTE: Address is different than previously reported

Email: mdelbalzo@umwa.org

2. Date: 03/06/2010

3. FEC Committee ID #: C00013342 This committee is a separate segregated fund. Its connected organization is a Labor Organization

Affiliated Committees/Organizations

UNITED MINE WORKERS OF AMERICA
18354 QUANTICO GATEWAY DR
SUITE 200
TRIANGLE, Virginia 22172
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Daniel J Kane
411 W LLOYD ST
PO Box 307
EBENSBURG, PA 15931
Title: SEC-TREAS
Phone # (703) 291-2406

Treasurer:

Daniel J Kane
411 W LLOYD ST
PO Box 307
EBENSBURG, Pennsylvania 15931
Title: SEC-TRAS
Phone # (703) 291-2406

Designated Agent(s):

Banks or Depositories

CITIBANK, FSB
1101 PENNSYLVANIA AVE, NW
WASHINGTNO, DC 20006

Signed: Daniel J Kane
Date Signed: 03/06/2010
Official Committee URL: www.umwa.org

(End FEC FORM 1)

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