FEC Form 1 for National Association of Convenience Stores Political Action CommitteeForm 1 for National Association of Convenience Stores Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1009238

1. National Association of Convenience Stores Political Action Committee

1600 Duke Street
Alexandria, VA 22314
Email: nacspac@nacsonline.com;cquat@nacsonline.com

2. Date: 05/27/2015

3. FEC Committee ID #: C00126763 This committee is a separate segregated fund. Its connected organization is a Trade Association
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

National Association of Convenience Stores
1600 Duke Street
Alexandria, Virginia 22314
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Caroline Quat
1600 Duke Street
Alexandria, VA 22314
Title: Custodian of Records
Phone # (703) 518-4292

Treasurer:

Mr. Lyle Beckwith
1600 Duke Street
Alexandria, Virginia 22314
Title: Treasurer
Phone # (703) 684-3600

Designated Agent(s):

Kelly Fink
1600 Duke Street
Alexandria, Virginia 22314
Title: Assistant Treasurer
Phone # (703) 518-4228

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1009238

1. National Association of Convenience Stores Political Action Committee

2. Date: 05/27/2015

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Mr. Lyle Beckwith
Date Signed: 05/27/2015

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1009238

1. National Association of Convenience Stores Political Action Committee

2. Date: 05/27/2015

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Mr. Lyle Beckwith Date Signed: 05/27/2015

(End FEC FORM 1)

Signed: Mr. Lyle Beckwith
Date Signed: 05/27/2015