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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-25050

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1. Domino PAC

    NOTE:Commmittee Name is different than previously reported

    1420 New York Avenue NW
    Suite 800
    Washington, DC 20005

    NOTE: Address is different than previously reported

2. Date: 08/25/2000

3. FEC Committee ID #: C00352591 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Van Boyette
1420 New York Avenue NW
Suite 800
Washington, DC 20005
Title: Treasurer
Phone # (202) 347-2980

Designated Agent(s):

Rachel Morrissey
1420 New York Avenue NW
Suite 800
Washington, DC 20005
Title: Assistant Treasurer
Phone # (202) 347-2980

Banks or Depositories

Allfirst Bank
Mail Code: 203-180
1123 15th Street NW
Washington, DC 20005

Signed: Mr. Van Boyette
Date Signed: 01/29/2002

(End FEC FORM 1)

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