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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-798935

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1. FUTURES INDUSTRY ASSOCIATION, INC. POLITICAL ACTION COMMITTEE/FIPAC

    NOTE:Commmittee Name is different than previously reported

    2001 PENNSYLVANIA AVE NW SUITE 600
    WASHINGTON, DC 20006
    Email: gsheetz@futuresindustry.org;ttaylor@futuresindustry.org

    NOTE: Email address is different than previously reported

2. Date: 07/17/2012

3. FEC Committee ID #: C00133389 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Futures Industry Association, Inc.
2001 Pennsylvania Avenue NW
Suite 600
Washington, DC 20006
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Ms Toby Taylor
2001 Pennsylvania Avenue NW
Suite 600
Washington, DC 20006
Title: Executive Assistant
Phone # (202) 466-5460

Treasurer:

Mr. Guy Sheetz
2001 Pennsylvania Avenue NW
Suite 600
Washington, DC 20006
Title: CFO
Phone # (202) 466-5460

Designated Agent(s):

Ms Toby Taylor
2001 Pennsylvania Avenue NW
Suite 600
Washington, DC 20006
Title: Executive Assistant
Phone # (202) 466-5460

Banks or Depositories

Wells Fargo Bank N.A.
20th & L Street NW
Washington, DC 20006

Signed: Mr. Guy Sheetz
Date Signed: 07/17/2012

(End FEC FORM 1)

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