FEC Form 1 for Brownstein Hyatt Farber Schreck Political Action CommitteeForm 1 for Brownstein Hyatt Farber Schreck Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-759690

1. Brownstein Hyatt Farber Schreck Political Action Committee

410 Seventeenth Street
Suite 2200
Denver, CO 80202
Email: sdemby@bhfs.com

2. Date: 01/25/2012

3. FEC Committee ID #: C00390583 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Brownstein Hyatt Farber Schreck
410 Seventeenth Street
Suite 2200
Denver, Colorado 80202
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Ashley Stewart
1350 I Street, NW
Suite 510
Washington, DC 20005
Title: Custodian of Records
Phone # (202) 296-7353

Treasurer:

Steven Demby
410 17th Street
Suite 2200
Denver, Colorado 80202
Title: Treasurer
Phone # (303) 223-1100

Designated Agent(s):

Judy A. Black
1350 I Street, NW
Suite 510
Washington, DC 20005
Title: Assistant Treasurer
Phone # (202) 872-5285

Banks or Depositories

Steele Street State Bank
1641 California Street
Suite 100
Denver, Colorado 80202

Signed: Mr. Steven Demby
Date Signed: 01/25/2012

(End FEC FORM 1)

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