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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1092674

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1. Citizen Revolt PAC

    203 S Union St
    Ste 300
    Alexandria, VA 22314
    Email: katie@dbcapitolstrategies.com

2. Date: 08/05/2016

3. FEC Committee ID #: C00623181

This committee is a political committee with both contribution and non-contribution accounts (Hybrid PAC).

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Sarah K Granger
203 S Union St
Ste 300
Alexandria, VA 22314
Title: Asst. Treasurer

Treasurer:

Dan Backer, Esq
203 S Union St
Ste 300
Alexandria, Virginia 22314
Title: Treasurer
Phone # (202) 210-5431

Designated Agent(s):

Sarah K Granger
203 S Union St
Ste 300
Alexandria, Virginia 22314
Title: Asst. Treasurer

Banks or Depositories

Access National Bank
4221 Walney Rd
Chantilly, Virginia 20151

Signed: Dan Backer, Esq
Date Signed: 08/05/2016

FORM TEXT-1

(End FEC FORM 1)

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