FEC Form 1 for GRASS ROOTS NORTH CAROLINA/FORUM FOR FIREARMS EDUC POL VICTORY FUNDForm 1 for GRASS ROOTS NORTH CAROLINA/FORUM FOR FIREARMS EDUC POL VICTORY FUND

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-185352

1. GRASS ROOTS NORTH CAROLINA/FORUM FOR FIREARMS EDUC POL VICTORY FUND

PO BOX 10684
RALEIGH, NC 27605

NOTE: Address is different than previously reported

Email: denny@truepatriot.org

2. Date: 07/17/2005

3. FEC Committee ID #: C00354605

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

Custodian of Records:

Dennis Nielsen
PO Box 524
Red Oak, NC 27856

Treasurer:

Dennis Nielsen
PO Box 524
Red Oak, North Carolina 27856

Designated Agent(s):

Joseph Mertz
PO Box 10684
Raleigh, North Carolina 27605

Banks or Depositories

Suntrust Bank
2008 E. Hwy 54
Durham, North Carolina 27713

Signed: Dennis Nielsen
Date Signed: 08/24/2005

(End FEC FORM 1)

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