FEC Form 1 for INTERNATIONAL UNION OF OPERATING ENGINEERS - LOCAL 101 POLITICAL ACTION COMMITTEEForm 1 for INTERNATIONAL UNION OF OPERATING ENGINEERS - LOCAL 101 POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-425207

1. INTERNATIONAL UNION OF OPERATING ENGINEERS - LOCAL 101 POLITICAL ACTION COMMITTEE

6601 WINCHESTER AVE
SUITE 280
KANSAS CITY, MO 64133
Email: dort101@kc.rr.com

2. Date: 04/01/2009

3. FEC Committee ID #: C00114850 This committee is a separate segregated fund. Its connected organization is a Labor Organization

Affiliated Committees/Organizations

Committee ID# C00114850
INTERNATIONAL UNION OF OPERATING ENGINEERS - LOCAL 101 POLITICAL ACTION COMMITTEE
6601 WINCHESTER AVE
SUITE 280
KANSAS CITY, Missouri 64133
Affiliated Relationship Code: Connected Organization

Custodian of Records:

DOROTHY V. THOMAS
6601 WINCHESTER AVENUE
SUITE 280
KANSAS CITY, MO 64133
Title: BOOKKEEPER
Phone # (816) 737-8600

Treasurer:

TERRY R. SIMPSON
6601 WINCHESTER AVENUE
SUITE 280
KANSAS CITY, Missouri 64133
Title: Treasurer
Phone # (816) 737-8600

Designated Agent(s):

Banks or Depositories

UNION BANK
7600 EAST 87th STREET
KANSAS CITY, Missouri 64138

Signed: TERRY R. SIMPSON
Date Signed: 07/17/2009

(End FEC FORM 1)

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