FEC Form 1 for SSA Marine Inc. Good Government FundForm 1 for SSA Marine Inc. Good Government Fund

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-118368

1. SSA Marine Inc. Good Government Fund

1131 SW Klickitat Way
Seattle, WA 98134
Fax: 206-624-5911
Email: andy.mclauchlan@ssamarine.com

2. Date: 04/26/2004

3. FEC Committee ID #: C00397893 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Committee ID# C00397893
SSA Marine Inc.
1131 SW Klickitat Way
Seattle, Washington 98134
Relationship: Connected Organization
Organization Type: Corporation

Custodian of Records:

Jill Jansen
1131 SW Klickitat Way
Seattle, WA 98134
Title: Executive Assistant
Phone # (206) 654-3523

Treasurer:

Andrew Ian McLauchlan
1131 SW Klickitat Way
Seattle, Washington 98134
Title: Senior Vice Presiden
Phone # (206) 654-3549

Designated Agent(s):

Mark Johnson
1850 M Street NW Suite 910
Washington, DC 20036
Title: Vice President
Phone # (202) 463-2517

Banks or Depositories

Bank of America
800 5th Avenue
Seattle, Washington 98104

Signed: Andrew McLauchlan
Date Signed: 04/26/2004
Official Committee FAX: 206-624-5911

(End FEC FORM 1)

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