FEC Form 1 for BREWERY SOFT DRINK BEER DISTR OPTICAL DENTAL MISC WORKERS WAREHOUSEMAN HELP LOCAL 830 PACForm 1 for BREWERY SOFT DRINK BEER DISTR OPTICAL DENTAL MISC WORKERS WAREHOUSEMAN HELP LOCAL 830 PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-270281

1. BREWERY SOFT DRINK BEER DISTR OPTICAL DENTAL MISC WORKERS WAREHOUSEMAN HELP LOCAL 830 PAC

12298 TOWNSEND ROAD
PHILADELPHIA, PA 19154
Fax: 2156761324
Email: dgrace@team830.org

2. Date: 01/22/2007

3. FEC Committee ID #: C00174847 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Teamsters Local Union #830
12298 Townsend Road
Philadelphia, Pennsylvania 19154
Relationship: Connected
Organization Type: Labor Organization

Custodian of Records:

Daniel H. Grace
12298 Townsend Road
Philadelphia, PA 19154
Title: Secretary-Treasurer
Phone # (215) 671-9850

Treasurer:

Daniel H. Grace
12298 Townsend Road
Philadelphia, Pennsylvania 19154
Title: Secretary-Treasurer
Phone # (215) 671-9850

Designated Agent(s):

Banks or Depositories

Commerce Bank
3930 Woodhaven Road
Philadelphia, Pennsylvania 19154

The Vanguard Group
P.O. Box 1110
Valley Forge, Pennsylvania 19482

Signed: Daniel H. Grace
Date Signed: 01/22/2007
Official Committee URL: www.team830.org
Official Committee FAX: 2156761324

(End FEC FORM 1)

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