FEC Form 1 for INTERNATIONAL UNION OF OPERATING ENGINEERS/LOCAL 17 POLITICAL ACTION COMMITTEEForm 1 for INTERNATIONAL UNION OF OPERATING ENGINEERS/LOCAL 17 POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-349843

1. INTERNATIONAL UNION OF OPERATING ENGINEERS/LOCAL 17 POLITICAL ACTION COMMITTEE

5959 VERSAILLES RD
LAKEVIEW, NY 14085
Fax: 7166272649
Email: opereng17@aol.com

2. Date: 05/06/2008

3. FEC Committee ID #: C00104455 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

Custodian of Records:

Alan Pero
5959 Versailles Road
Lakeview, NY 14085

Treasurer:

Alan Pero
5959 Versailles Road
Lakeview, New York 14085

Designated Agent(s):

Alan Pero
5959 Versailles Road
Lakeview, New York 14085
Title: Treasurer
Phone # (716) 627-2648

Banks or Depositories

M & T Bank
one fountain plaza
buffalo, New York 14202

Signed: Alan Pero
Date Signed: 07/14/2008
Official Committee FAX: 7166272649

(End FEC FORM 1)

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