FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-270720
1. American Success Political Action Committee
1155 21st Street NWSuite 300
Washington, DC 20036
Email: mgkelley@wms-jen.com
2. Date: 01/10/2007
3. FEC Committee ID #: C00336644This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
Affiliated Committees/Organizations
NONE
, ____
Custodian of Records:
William Canfield
1155 21st Street NW
Suite 300
Washington, DC 20036
Treasurer:
Meredith Kelley
1155 21st Street NW
Suite 300
Washington, DC 20036
Title: Treasurer
Phone # (202) 659-8201
Designated Agent(s):
Banks or Depositories
Wachovia
PO Box 13327
Roanoke, Virginia 24040
Signed: Meredith Kelley
Date Signed: 01/10/2007
(End FEC FORM 1)
Date Signed: 01/10/2007