FEC Form 1 for Amusement & Music Operators Association Political Action CommitteeForm 1 for Amusement & Music Operators Association Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-364540

1. Amusement & Music Operators Association Political Action Committee

33 W. Higgins Road
Suite 830
South Barrington, IL 60010
Email: rbuttermore@prodigy.net

2. Date: 09/30/2008

3. FEC Committee ID #: C00340018 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

Amusement & Music Operators Association
33 W Higgins Rd.
Suite 830
South Barrington, Illinois 60010
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Renie Buttermore
33 W Higgins Rd.
Suite 830
South Barrington, IL 60010
Title: Custodian of Records
Phone # (800) 937-2662

Treasurer:

Mr. John D. Kelleher
33 W. Higgins Road
Suite 830
South Barrington, Illinois 60010
Title: Treasurer
Phone # (800) 937-2662

Designated Agent(s):

Banks or Depositories

Harris Bank
PO Boc 94033
Palatine, Illinois 60094

Signed: Mr. John D. Kelleher
Date Signed: 09/30/2008

(End FEC FORM 1)

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