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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1038610

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1. SUPIMA POLITICAL ACTION COMMITTEE-SUPAC

    4141 E BROADWAY
    PHOENIX, AZ 85040
    Email: nancy@supima.com

2. Date: 01/01/2016

3. FEC Committee ID #: C00038927 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

Supima
4141 E. Broadway Rd.
Phoenix, Arizona 85040
Affiliated Relationship Code: Connected Organization

Custodian of Records:

NANCY F BOYD
4141 E. BROADWAY RD.
PHOENIX, AZ 85040
Title: OFFICE MANAGER
Phone # (602) 792-6002

Treasurer:

Mr. MARC A LEWKOWITZ
2007 E. TAXIDEA WAY
PHOENIX, Arizona 85048
Title: Treasurer
Phone # (602) 792-6002

Designated Agent(s):

Banks or Depositories

BANK OF AMERICA
P.O. BOX 29966
PHOENIX, Arizona 85038

Signed: Mr. MARC A LEWKOWITZ
Date Signed: 01/08/2016
Official Committee URL: www.supima.com

FORM TEXT-1

(End FEC FORM 1)

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