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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-809721

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1. Blank Rome PAC

    600 New Hampshire Avenue, NW
    Washington, DC 20037
    Email: lucian-s@blankrome.com

2. Date: 05/25/2012

3. FEC Committee ID #: C00150797

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Ms. Ashley Davis
600 New Hampshire Avenue
Washington, DC 20037
Title: Principal
Phone # (202) 772-5893

Designated Agent(s):

Banks or Depositories

PNC Bank
2600 Virginia Avenue, NW
Washington, DC 20037

Signed: Ms. Ashley Davis
Date Signed: 05/25/2012

FORM TEXT

(End FEC FORM 1)

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