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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-428859

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1. Philip A. Hart Democratic Club

    38875 Harper Avenue
    Clinton Township, MI 48036

    NOTE: Address is different than previously reported

    Email: mad12157@hotmail.com

2. Date: 08/05/2009

3. FEC Committee ID #: C00224717 This committee is a Local committee of the Party.

Affiliated Committees/Organizations

Michigan Democratic Party
606 Townsend
Lansing, Michigan 48933
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Michelle DeBeaussaert
230 North Avenue
Mt. Clemens, MI 48043
Title: Treasurer
Phone # (586) 468-5512

Treasurer:

Michelle DeBeaussaert
230 North Avenue
Mt. Clemens, Michigan 48043
Title: Treasurer
Phone # (586) 468-5512

Designated Agent(s):

Banks or Depositories

Community Central Bank
100 North Main Street
Mount Clemens, Michigan 48043

Signed: Michelle DeBeaussaert
Date Signed: 08/05/2009

(End FEC FORM 1)

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