FEC Form 1 for Direct Selling Association Political Action CommitteeForm 1 for Direct Selling Association Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-736722

1. Direct Selling Association Political Action Committee

1667 K Street, NW
Suite 1100
Washington, DC 20006
Email: governmentrelations@dsa.org

2. Date: 07/18/2011

3. FEC Committee ID #: C00078535 This committee is a separate segregated fund. Its connected organization is a Trade Association
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Direct Selling Association
1667 K Street NW
Suite 1100
Washington, DC 20006
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. John Webb
1667 K St. NW
Suite 1100
Washington, DC 20006
Title: Counsel
Phone # (202) 416-6410

Treasurer:

Mr. Adolfo Franco
1667 K St.
Suite 1100
Washington, DC 20006
Title: Executive VP
Phone # (202) 452-8866

Designated Agent(s):

Banks or Depositories

Wachovia Bank
P.O. Box 563966
Charlotte, North Carolina 28262

Signed: Mr. Adolfo Franco
Date Signed: 07/18/2011

(End FEC FORM 1)

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