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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1050256

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1. Black PAC

    1800 Massachusetts Ave., NW
    Washington, DC 20036
    Email: treas@seiu.org

2. Date: 02/18/2016

3. FEC Committee ID #: C00609388

This committee is an independent expenditure-only political committee (Super PAC).

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Laurie Singer
1800 Massachusetts Ave., NW
Washington, DC 20036
Title: Custodian of Records
Phone # (202) 730-7000

Treasurer:

Gerald Hudson
1800 Massachusetts Ave., NW
Washington, DC 20036
Title: Treasurer
Phone # (202) 730-7000

Designated Agent(s):

Banks or Depositories

Amalgamated Bank
1825 K Street, NW
Washington, DC 20036

Signed: Gerald Hudson
Date Signed: 02/18/2016

FORM TEXT-1

(End FEC FORM 1)

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