FEC Form 1 for Continuing A Majority Party Action Committee (CAMPAC)Form 1 for Continuing A Majority Party Action Committee (CAMPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-732032

1. Continuing A Majority Party Action Committee (CAMPAC)

5915 Eastman Avenue
Suite 100
Midland, MI 486406824
Email: jackie.medema@ahpplc.com

2. Date: 06/20/2011

3. FEC Committee ID #: C00350462

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
In addition, this committee is a Leadership PAC.

Affiliated Committees/Organizations

Committee ID# C00497388
Republican Leadership Committee 2011
228 S Washington Street
Suite 115
Alexandria, Virginia 223145404
Affiliated Relationship Code: Joint Fundraising Representative

David Lee Camp
5905 Wimbledon Court
Midland, Michigan 486427004
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

Jacqueline M. Medema
5915 Eastman Avenue
Suite 100
Midland, MI 486406824
Title: Treasurer
Phone # (989) 835-7721

Treasurer:

Jacqueline M. Medema
5915 Eastman Avenue
Suite 100
Midland, Michigan 486406824
Title: Treasurer
Phone # (989) 835-7721

Designated Agent(s):

Banks or Depositories

CHEMICAL BANK & TRUST
333 E Main Street
Midland, Michigan 486406511

BB&T
1909 K Street NW
Washington, DC 200061152

Signed: Jacqueline M. Medema
Date Signed: 06/20/2011

(End FEC FORM 1)

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