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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-266447

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1. Reform Party of Pennsylvania

    44 Primrose Dr
    E Stroudsburg, PA 18301
    Email: reform.pa.fec@gmail.com

2. Date: 12/23/2006

3. FEC Committee ID #: C00338616 This committee is a committee of the State Party.

Affiliated Committees/Organizations

Custodian of Records:

Thomas Rake
44 Primrose Dr
E Stroudsburg, PA 18301
Title: Treasurer
Phone # (570) 223-0764

Treasurer:

Thomas Rake
44 Primrose Dr
E Stroudsburg, Pennsylvania 18301

Designated Agent(s):

Banks or Depositories

Signed: Thomas Rake
Date Signed: 12/23/2006

(End FEC FORM 1)

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