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-409562

1. NATIONAL CLUB ASSOCIATION POLITICAL ACTION COMMITTEE (CLUBPAC)

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

2. Date: 03/25/2009

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:

Susanne R. Wegryzn
1201 15th St., NW
Suite 450
Washington, DC 20005

Treasurer:

Susanne R. Wegryzn
1201 15th St., NW
Suite 450
Washington, DC 20005
Title: Treasurer
Phone # (202) 822-9822

Designated Agent(s):

Banks or Depositories

Wachovia Bank
P.O. Box 563966
Charlotte, North Carolina 28256

Signed: Susanne R. Wegryzn
Date Signed: 03/25/2009

(End FEC FORM 1)

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