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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-744781

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1. ACPAC ACA INTERNATIONAL POLITICAL ACTION COMMITTEE

    4040 W 70TH ST
    MINNEAPOLIS, MN 55435
    Email: andrew@acainternational.org

2. Date: 09/15/2011

3. FEC Committee ID #: C00034785 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Michelle Andrew
4040 W 70th St
Minneapolis, MN 55439
Title: Administrative Asst.
Phone # (952) 926-6547

Treasurer:

Adam Peterman
509 2nd St. NE
Washington, DC 20002
Title: Director
Phone # (202) 547-2670

Designated Agent(s):

Patrick Morris
4040 W. 70th St.
Minneapolis, Minnesota 55435
Title: CEO
Phone # (952) 926-6547

Banks or Depositories

US Bank
344 Jackson
St. Paul, Minnesota 55104

Signed: Adam Peterman
Date Signed: 09/15/2011
Official Committee URL: www.acainternational.org

(End FEC FORM 1)

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