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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-444784

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1. Beall's PAC USA, Inc.

    PO Box 1337
    Bradenton, FL 342061337
    Email: kgoldstein@beallsinc.com

    NOTE: Email address is different than previously reported

2. Date: 01/31/2010

3. FEC Committee ID #: C00378661 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Beall's Inc.
P.O. Box 25207
Bradenton, Florida 34206
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Michael Maddaloni
P O Box 25207
Bradenton, Florida 34206
Title: Treasurer
Phone # (941) 744-4309

Designated Agent(s):

Banks or Depositories

BB&T Bank
6208 14th Street West
Bradenton, Florida 34207

Signed: Michael Maddaloni
Date Signed: 01/14/2010

(End FEC FORM 1)

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