FEC Form 1 for NATIONAL CLUB ASSOCIATION POLITICAL ACTION COMMITTEE (CLUBPAC)Form 1 for NATIONAL CLUB ASSOCIATION POLITICAL ACTION COMMITTEE (CLUBPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1041219

1. NATIONAL CLUB ASSOCIATION POLITICAL ACTION COMMITTEE (CLUBPAC)

1201 15TH STREET NW SUITE 450
WASHINGTON, DC 20005
Email: steele@nationalclub.org

2. Date: 01/21/2016

3. FEC Committee ID #: C00165472 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 Club Association
1201 15th Street, NW
Suite 450
Wasington, DC 20005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Henry Wallmeyer
1201 15th St., NW
Ste. 450
Washington, DC 20005
Title: Treasurer
Phone # (202) 822-9822

Treasurer:

Henry Wallmeyer
1201 15th St., NW
Ste. 450
Washington, DC 20005
Title: Treasurer
Phone # (202) 822-9822

Designated Agent(s):

Banks or Depositories

Citibank, N.A.
1101 Pennsylvania Ave.
11th Floor
Washington, DC 20004

Signed: Henry Wallmeyer
Date Signed: 01/21/2016

(End FEC FORM 1)

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