FEC Form 1 for NATIONAL FUNERAL DIRECTORS ASSOCIATION OF THE U S INC POLITICAL ACTION CMTE (NFDA-PAC)Form 1 for NATIONAL FUNERAL DIRECTORS ASSOCIATION OF THE U S INC POLITICAL ACTION CMTE (NFDA-PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-150213

1. NATIONAL FUNERAL DIRECTORS ASSOCIATION OF THE U S INC POLITICAL ACTION CMTE (NFDA-PAC)

13625 BISHOP'S DRIVE
BROOKFIELD, WI 53005
Fax: 2627896977
Email: bholton@nfda.org

2. Date: 11/02/2004

3. FEC Committee ID #: C00204008 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

National Funeral Directors Association Inc
13625 Bishop's Drive
Brookfield, Wisconsin 53005
Relationship: Connected
Organization Type: Corporation W/O Capital Stock

Custodian of Records:

Mr. William R. Holton
13625 Bishop's Drive
Brookfield, WI 53005
Title: Accounting Manager
Phone # (262) 789-1880

Treasurer:

Mr. John J. Hogan
136-25 41st Ave
Flushing, New York 11355
Title: Treasurer
Phone # (718) 939-3100

Designated Agent(s):

Mark D Musgrove, CFSP
1152 Olive St
Eugene, Oregon 974013547
Title: President
Phone # (541) 686-2818

R Doggett Whitaker, Jr
1704 College St
Newberry, South Carolina 291082640
Title: President-elect
Phone # (803) 276-5000

Mr. John J. Hogan
136-25 41st Ave
Flushing, New York 11355
Title: Secretary
Phone # (718) 939-3100

Banks or Depositories

Associated Bank
401 E. Kilbourn
Milwaukee, Wisconsin 53202

Signed: Mr. John J. Hogan
Date Signed: 11/02/2004
Official Committee FAX: 2627896977

(End FEC FORM 1)

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