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-836667

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

6601 WINCHESTER AVE
SUITE 280
KANSAS CITY, MO 64133
Email: lmc@iuoelocal101.org;lmc@iuoelocal101.org

NOTE: Email address is different than previously reported

2. Date: 12/04/2012

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:

Treasurer:

TERRY R. SIMPSON
6601 WINCHESTER AVENUE
SUITE 280
KANSAS CITY, Missouri 64133

Designated Agent(s):

Banks or Depositories

COMMUNITY BANK OF PLEASANT HILL
P.O. BOX 30
PLEASANT HILL, Missouri 64080

Signed: TERRY R. SIMPSON
Date Signed: 12/04/2012

(End FEC FORM 1)

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