FEC Form 1 for LOCAL 500 PACForm 1 for LOCAL 500 PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-329560

1. LOCAL 500 PAC

3460 NORTH DELAWARE AVE
SUITE 301
PHILADELPHIA, PA 19134
Fax: 2152915536
Email: l500fooddr@aol.com

2. Date: 04/03/2008

3. FEC Committee ID #: C00094904 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Teamsters Local Union 500
3460 N Delaware Ave
Suite 301
Philadlephia, Pennsylvania 19134
Relationship: Connected
Organization Type: Labor Organization

Custodian of Records:

Mr. James Kelly
3460 North Delaware Ave
Suite 301
Philadelphia, PA 19134
Title: Treasurer
Phone # (215) 291-9540

Treasurer:

Mr. James Kelly
3460 North Delaware Ave
Suite 301
Philadelphia, Pennsylvania 19134
Title: Treasurer
Phone # (215) 291-9540

Designated Agent(s):

Banks or Depositories

Wachovia Bank
P O Box 563966
Charlotte, North Carolina 28262

Signed: Mr. James Kelly
Date Signed: 04/03/2008
Official Committee FAX: 2152915536

(End FEC FORM 1)

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