FEC Form 1 for Jerry's Political Action Committee (Jerry's PAC)Form 1 for Jerry's Political Action Committee (Jerry's PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-403019

1. Jerry's Political Action Committee (Jerry's PAC)

NOTE:Commmittee Name is different than previously reported

Village Station, PO Box 19
New York, NY 10014
Fax: 2129945386
Email: jerryspac@gmail.com

2. Date: 02/09/2009

3. FEC Committee ID #: C00363317

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# C00290825
Nadler for Congress - Rep. Jerrold Nadler
PO Box 40
New York, New York 10014
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

Robert M. Gottheim, Esq.
Village Station, PO Box 19
New York, NY 10014
Title: Counsel
Phone # (212) 352-0370

Treasurer:

Ira N. Brophy
Village Station, PO Box 19
New York, New York 10014
Title: Treasurer
Phone # (212) 352-0370

Designated Agent(s):

Banks or Depositories

Citibank, NA
172 West 72nd Street
New York, New York 10023

Signed: Ira N. Brophy
Date Signed: 02/09/2009
Official Committee FAX: 2129945386

(End FEC FORM 1)

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