FEC Form 1 for Tennessee Road Builders Association Political Action CommitteeForm 1 for Tennessee Road Builders Association Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-185638

1. Tennessee Road Builders Association Political Action Committee

P.O. Box 190535
Nashville, TN 372190535
Fax: 6152556937

2. Date: 04/22/2005

3. FEC Committee ID #: C00215012 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Tennessee Road Builders Association
213 5th Ave N
Nashville, Tennessee 372191908
Relationship: Connected
Organization Type: Trade Association

Custodian of Records:

Kent D Starwalt
P.O. Box 190535
Nashville, TN 372190535
Phone # (615) 255-5751

Treasurer:

Todd Carson
P.O. Box 190535
Nashville, Tennessee 372190535
Phone # (615) 255-5751

Designated Agent(s):

Banks or Depositories

AmSouth
AmSouth Center
Nashville, Tennessee 372370204

Signed: Todd Carson
Date Signed: 09/02/2005
Official Committee FAX: 6152556937

(End FEC FORM 1)

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