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FEC Form 1 for WIN-PAC of Winn-Dixie Stores Inc.Form 1 for WIN-PAC of Winn-Dixie Stores Inc.

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-118758

1. WIN-PAC of Winn-Dixie Stores Inc.

    5050 Edgewood Court
    Jacksonville, FL 32254

2. Date: 05/03/2004

3. FEC Committee ID #: C00033092 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Winn-Dixie Stores Inc.
5050 Edgewood Court
Jacksonville, Florida 32254
Relationship: Connected
Organization Type: Corporation

Custodian of Records:

Jeffrey Gleason
5050 Edgewood Court
Jacksonville, FL 32254

Treasurer:

Jeffrey Gleason
5050 Edgewood Court
Jacksonville, Florida 32254

Designated Agent(s):

Banks or Depositories

Signed: Jeffrey Gleason
Date Signed: 05/04/2004

(End FEC FORM 1)


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