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FEC Form 1 for Kmart Political Action CommitteeForm 1 for Kmart Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-136092


1. Kmart Political Action Committee

    Kmart Corporation
    3100 West Big Beaver Road
    Troy, MI 48084
    Fax: 248-463-5513

2. Date: 09/24/2004

3. FEC Committee ID #: C00085373 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Kmart Corporation
3100 West Big Beaver Road
Troy, Michigan 48084
Organization Type: Corporation

Custodian of Records:

PACS
7700 Old Branch Avenue
Suite D-103
Clinton, MD 20735
Title: Custodian of Records
Phone # (301) 868-1888

Treasurer:

Jon Gieselman
Kmart Corporation
3100 West Big Beaver Road
Troy, Michigan 48084
Title: Treasurer
Phone # (248) 463-5277

Designated Agent(s):

Wade Williams
PAC Services LLC
7700 Old Branch AvenueSuite D-103
Clinton, Maryland 20735
Phone # (301) 868-1888

Banks or Depositories

Standard Federal Bank
2600 West Big Beaver Road
Troy, Michigan 48084

Signed: Jon Gieselman
Date Signed: 09/24/2004
Official Committee URL: www.kmart.com
Official Committee FAX: 248-463-5513

(End FEC FORM 1)


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