FEC Form 1 for LABORERS LOCAL NO. 91 POLITICAL ACTION FUNDForm 1 for LABORERS LOCAL NO. 91 POLITICAL ACTION FUND

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-167110

1. LABORERS LOCAL NO. 91 POLITICAL ACTION FUND

2556 SENECA AVENUE
NIAGARA FALLS, NY 14305
Fax: 7162973414

2. Date: 03/11/2005

3. FEC Committee ID #: C00155069 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Laborers' International Union of North America - Local No. 91
2556 Seneca Avenue
Niagara Falls, New York 14305
Relationship: Affiliate
Organization Type: Labor Organization

Custodian of Records:

Enrico D. Liberale
2556 Seneca Avenue
Niagara Falls, NY 14305
Title: Treasurer

Treasurer:

Enrico D. Liberale
6676 Cloverleaf Court
Niagara Falls, New York 14304
Title: Treasurer

Designated Agent(s):

Robert Connolly
1289 - 95th Street
Niagara Falls, New York 14304

Banks or Depositories

M&T Bank
750 Main Street
Niagara Falls, New York 14301

Signed: Enrico D. Liberale
Date Signed: 03/11/2005
Official Committee FAX: 7162973414

(End FEC FORM 1)

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