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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-405758

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1. UNITED FOOD & COMMERCIAL WORKERS INTERNATIONAL UNION, ACTIVE BALLOT CLUB

    1775 K STREET, N.W.
    WASHINGTON, DC 20006
    Email: broberts@ufcw.org

2. Date: 02/26/2009

3. FEC Committee ID #: C00002766 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

UNITED FOOD AND COMMERCIAL WORKERS INTERNATIONAL UNION
1775 K STREET N.W.
WASHINGTON, DC 200061598
Affiliated Relationship Code: Connected Organization

INTERNATIONAL CHEMICAL WORKERS UNION L
1799 AKRON PENNINSULA ROAD
AKRON, Ohio 443134847
Affiliated Relationship Code: Affiliated Committee

RETAIL WHOLESALE & DEPARTMENT STORE UN
30 EAST 29TH STREET
NEW YORK, New York 10016
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

ANTHONY M. PERRONE
1775 K STREET N.W.
WASHINGTON, DC 200061598
Title: SECRETARY-TREASURER
Phone # (202) 223-3111

Treasurer:

ANTHONY M. PERRONE
1775 K STREET N.W.
WASHINGTON, DC 200061598
Title: SECRETARY-TREASURER
Phone # (202) 223-3111

Designated Agent(s):

Banks or Depositories

CHEVY CHASE BANK
6151 CHEVY CHASE DRIVE
LAUREL, Maryland 20707

Signed: ANTHONY M. PERRONE
Date Signed: 02/27/2009

(End FEC FORM 1)

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