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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1033598

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1. International Union of Operating Engineers Local No. 12 Voluntary Legislative Fund

    NOTE:Commmittee Name is different than previously reported

    150 East Corson St.
    Pasadena, CA 91103
    Email: sshin@kaufmanlegalgroup.com

2. Date: 11/19/2015

3. FEC Committee ID #: C00219568 This committee is a separate segregated fund. Its connected organization is a Labor Organization

Affiliated Committees/Organizations

International Union of Operating Engineers, Local No. 12
150 East Corson St.
Pasadena, California 91103
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Carl L. Mendenhall
150 East Corson St.
Pasadena, CA 91103
Title: Treasurer
Phone # (626) 792-8900

Treasurer:

Carl L. Mendenhall
150 East Corson St.
Pasadena, California 91103
Title: Treasurer
Phone # (626) 792-8900

Designated Agent(s):

Carl L Mendenhall
150 East Corson St.
Pasadena, California 91103
Title: Treasurer
Phone # (626) 792-8900

Banks or Depositories

City National Bank
89 South Lake Ave.
Pasadena, California 91101

Signed: Carl L. Mendenhall
Date Signed: 11/19/2015

(End FEC FORM 1)

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