FEC Form 1 for PAC for a ChangeForm 1 for PAC for a Change

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1163044

1. PAC for a Change

777 S. Figueroa St. Suite 4050
Los Angeles, CA 90017
Email: sshin@kaufmanlegalgroup.com;lbeaver@kaufmanlegalgroup.com

NOTE: Email address is different than previously reported

2. Date: 05/18/2017

3. FEC Committee ID #: C00342048

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

Committee ID# C00639864
CA Boxer/Schiff Committee
777 S. Figueroa St. Suite 4050
Los Angeles, California 90017
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Stephen J. Kaufman
777 S. Figueroa St. Suite 4050
Los Angeles, CA 90017
Title: Assistant Treasurer
Phone # (213) 452-6565

Treasurer:

Sim Farar
914 Westwood Blvd, Suite 808
Los angeles, California 90024
Title: Treasurer
Phone # (323) 936-7816

Designated Agent(s):

Stephen J. Kaufman
777 S. Figueroa St. Suite 4050
Los Angeles, California 90017
Title: Assistant Treasurer
Phone # (213) 452-6565

Banks or Depositories

California Bank & Trust
550 S. Hope Street Suite 100
Los Angeles, California 90010

Signed: Sim Farar
Date Signed: 05/18/2017

FORM TEXT-1

(End FEC FORM 1)

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