FEC Form 1 for Cracker Barrel Old Country Store Inc. Citizens for Political AccountabilityForm 1 for Cracker Barrel Old Country Store Inc. Citizens for Political Accountability

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-84768

1. Cracker Barrel Old Country Store Inc. Citizens for Political Accountability

P.O. 787
305 Hartmann Dr.
Lebanon, TN 370880787
Fax: 0-

2. Date: 10/10/2002

3. FEC Committee ID #: C00252791 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Cracker Barrel Old Country Store Inc.
P.O. Box 787
Lebanon, Tennessee 37087
Relationship: connected
Organization Type: Corporation

Custodian of Records:

Phone # 0

Treasurer:

Mr. Dwayne Evans
P.O. 787
305 Hartmann Dr.
Lebanon, Tennessee 370880787
Phone # 0

Designated Agent(s):

Banks or Depositories

Wilson Bank & Trust
623 West Main Street
Lebanon, Tennessee 37087

Signed: Mr. Dwayne Evans
Date Signed: 10/10/2002
Official Committee FAX: 0-

FORM TEXT

(End FEC FORM 1)

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