FEC Form 1 for Empire Political Action CommitteeForm 1 for Empire Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-803805

1. Empire Political Action Committee

PO Box 15033
Washington, DC 20003
Email: empirepac@gmail.com

2. Date: 07/25/2012

3. FEC Committee ID #: C00477067

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
In addition, this committee is a Leadership PAC.

Affiliated Committees/Organizations

Kirsten E. Gillibrand
236 Massachusetts Ave., NE
Suite 110
Washington, DC 20002
Affiliated Relationship Code: Leadership PAC Sponsor

Committee ID# C00525600
Off the Sidelines PAC
P.O. Box 78182
Washington, DC 20003
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Keith D. Lowey
P.O. Box 15033
Washington, DC 20003
Title: Treasurer
Phone # (508) 543-1720

Treasurer:

Keith D. Lowey
P.O. Box 15033
Washington, DC 20003
Title: Treasurer
Phone # (508) 543-1720

Designated Agent(s):

Banks or Depositories

Bank of America
201 Pennsylvania Ave SE
Washington, DC 20003

Bank of America
16 School Street
Foxboro, Massachusetts 02035

Signed: Keith D. Lowey
Date Signed: 08/10/2012

(End FEC FORM 1)

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