FEC Form 1 for National Beer Wholesalers Association Political Action CommitteeForm 1 for National Beer Wholesalers Association Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-192572

1. National Beer Wholesalers Association Political Action Committee

1101 King Street
Suite 600
Alexandria, VA 22314
Fax: 703-683-8965
Email: lauglis@nbwa.org

2. Date: 11/22/2005

3. FEC Committee ID #: C00144766 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

National Beer Wholesalers Association
1101 King Street
Suite 600
Alexandria, Virginia 22314
Relationship: Connected
Organization Type: Trade Association

Custodian of Records:

Mrs. Diane Mahoney
1101 King Street
Suite 600
Alexandria, VA 22314
Title: Mgr Registrations
Phone # (703) 683-4300

Treasurer:

Mr. Craig A. Purser
1101 King Street
Suite 600
Alexandria, Virginia 22314
Title: President
Phone # (703) 683-4300

Designated Agent(s):

Linda Auglis
1101 King Street
Suite 600
Alexandria, Virginia 22314
Title: Dir. Pol. Affairs
Phone # (703) 683-4300

Banks or Depositories

Wachovia Bank NA
Regional Servicenter VA 7300
PO Box 40031
Roanoke, Virginia 240220031

Signed: Mr. Craig A. Purser
Date Signed: 11/22/2005
Official Committee FAX: 703-683-8965

(End FEC FORM 1)

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