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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1678976

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1. 1199 SEIU United Healthcare Workers East Home Care Political Action Fund

    NOTE:Commmittee Name is different than previously reported

    498 Seventh Avenue, 24 Floor
    New York, NY 10018
    Email: helen.schaub@1199.org,politicalaction@1199.org

    NOTE: Email address is different than previously reported

2. Date: 01/20/2023

3. FEC Committee ID #: C00344531 This committee is a separate segregated fund. Its connected organization is a Labor Organization

Affiliated Committees/Organizations

1199 SEIU United Healthcare Workers East
498 Seventh Avenue, 24th Floor
New York, New York 10018
Affiliated Relationship Code: Connected Organization

1199 SEIU United Healthcare Workers Ea
498 Seventh Ave, 24 Floor
New York, New York 10018
Affiliated Relationship Code: Affiliated Committee

SEIU COPE (Service Employees Internati
1800 Massachusetts Ave. NW
Washington, DC 20036
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Helen Schaub
498 Seventh Avenue, 24th Floor
New York, NY 10018
Title: Treasurer
Phone # (212) 603-3782

Treasurer:

Helen Schaub
498 Seventh Ave, 24th Floor
New York, New York 10018
Title: Treasurer
Phone # (212) 603-3782

Designated Agent(s):

Dell Smitherman
498 Seventh Avenue, 24th Floor
New York, New York 10018
Title: Assistant Treasurer
Phone # (212) 857-4324

Banks or Depositories

TD Bank
1710 Route 70 East
Cherry Hill, New Jersey 08034

Signed: Helen Schaub
Date Signed: 01/20/2023

FORM TEXT-1

(End FEC FORM 1)

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