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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-102246

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1. Operating Engineers Local # 649 Political Action Committee

    6408 W. Plank Rd.
    Peoria, IL 61604
    Fax: 3096970025
    Email: locsec@iuoe649.org

2. Date: 09/17/2003

3. FEC Committee ID #: C00225573 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Darren D. Smith
P.O. Box 409
Dallas City, Illinois 62330

Designated Agent(s):

Banks or Depositories

Signed: Darren D. Smith
Date Signed: 12/22/2003
Official Committee FAX: 3096970025

(End FEC FORM 1)

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