FEC Form 1 for Local 32BJ Service Employees International Union American Dream Political Action FundForm 1 for Local 32BJ Service Employees International Union American Dream Political Action Fund

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-524670

1. Local 32BJ Service Employees International Union American Dream Political Action Fund

101 Avenue of the Americas
New York, NY 10013
Email: AHirsh@seiu32bj.org

NOTE: Email address is different than previously reported

2. Date: 12/17/2010

3. FEC Committee ID #: C00355289 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Alison E. Hirsh
101 Avenue of the Americas
New York, New York 10013
Title: Treasurer
Phone # (212) 388-3058

Designated Agent(s):

Banks or Depositories

TD Bank
25 Hudson St.
New York, New York 10013

Signed: Alison E Hirsh
Date Signed: 12/17/2010

(End FEC FORM 1)

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