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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-864374

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1. AMERICAN MARITIME OFFICERS RETIREES ASSOCIATION VOLUNTARY POLITICAL ACTION FUND

    PO Box 66
    Dania Beach, FL 330040066
    Email: theaton@amo-union.org;sscott@amo-union.org

    NOTE: Email address is different than previously reported

2. Date: 04/09/2013

3. FEC Committee ID #: C00089557 This committee is a separate segregated fund. Its connected organization is a Labor Organization
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

AMERICAN MARITIME OFFICERS
601 SOUTH FEDERAL HWY
DANIA BEACH, Florida 33004
Affiliated Relationship Code: Connected Organization

Committee ID# C00027532
AMERICAN MARITIME OFFICERS VOLUNTARY P
2 West Dixie Highway
Dania Beach, Florida 33004
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Jose Leonard
PO Box 66
Dania Beach, FL 330040066
Title: Treasurer
Phone # (954) 921-2221

Treasurer:

Jose Leonard
PO Box 66
Dania Beach, Florida 330040066
Title: Treasurer
Phone # (954) 921-2221

Designated Agent(s):

Banks or Depositories

Paradise Bank
540 North Federal Hwy
Ft. Lauderdale, Florida 33301

Signed: Jose Leonard
Date Signed: 04/09/2013

(End FEC FORM 1)

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