FEC Form 1 for AX PACForm 1 for AX PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-869477

1. AX PAC

1006 PENDLETON STREET
ALEXANDRIA, VA 22314
Email: kevin@bsbsolutions.net

2. Date: 01/06/2012

3. FEC Committee ID #: C00506535

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

Candidate ID# H0WI07051
SEAN DUFFY
2906 CITY HEIGHTS ROAD
ASHLAND, Wisconsin 54806
Affiliated Relationship Code: Leadership PAC Sponsor

Blue Ox Victory
P.O. Box 538
Wausau, Wisconsin 544020538
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Mr. Kevin Jahns
1006 Pendleton Street
Alexandria, VA 22314
Title: Treasurer

Treasurer:

Mr. Kevin Jahns
1006 Pendleton Street
Alexandria, Virginia 22314
Title: Treasurer
Phone # (703) 683-6703

Designated Agent(s):

Banks or Depositories

Burke & Herbert Bank & Trust Company
306 E. Monroe Ave.
Alexandria, Virginia 22301

River Valley Bank
101 Scott Street
Wausau, Wisconsin 54403

Signed: Mr. Kevin Jahns
Date Signed: 05/01/2013

(End FEC FORM 1)

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