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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-713193

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1. Citizen Beztak

    3998 Kipling Ave.
    Berkley, MI 48072

    NOTE: Address is different than previously reported

    Email: enengquist@beztak.com

    NOTE: Email address is different than previously reported

2. Date: 02/03/2011

3. FEC Committee ID #: C00349761 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Chris Engquist
3998 Kipling Ave.
Suite 250
Berkley, MI 48072
Title: Treasurer
Phone # (248) 855-5400

Treasurer:

Chris Engquist
3998 Kipling Ave.
Suite 250
Berkley, Michigan 48072
Title: Treasurer
Phone # (248) 855-5400

Designated Agent(s):

Banks or Depositories

Signed: Chris Engquist
Date Signed: 02/03/2011

(End FEC FORM 1)

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