FEC Form 1 for PAYLESS SHOESOURCE INC POLITICAL ACTION COMMITTEEForm 1 for PAYLESS SHOESOURCE INC POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-270548

1. PAYLESS SHOESOURCE INC POLITICAL ACTION COMMITTEE

3231 E 6TH ST
PO BOX 1189
TOPEKA, KS 66607
Fax: 7852956094
Email: arlen.zentner@payless.com

2. Date: 01/23/2007

3. FEC Committee ID #: C00319368 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Committee ID# C00319368
PAYLESS SHOESOURCE INC POLITICAL ACTION COMMITTEE
3231 E 6TH ST
PO BOX 1189
TOPEKA, Kansas 66607
Relationship: Connected
Organization Type: Corporation

Custodian of Records:

Treasurer:

Ullrich Porzig
, ____
Title: Treasurer
Phone # (785) 233-5171

Designated Agent(s):

Banks or Depositories

Kaw Valley Bank and Trust
, ____

Signed: Ullrich Porzig
Date Signed: 01/23/2007
Official Committee FAX: 7852956094

(End FEC FORM 1)

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