FEC Form 1 for INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS, LOCAL 42 POLITICAL ACTION COMMITTEEForm 1 for INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS, LOCAL 42 POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1055727

1. INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS, LOCAL 42 POLITICAL ACTION COMMITTEE

6320 Manchester Ave.
Suite 42A
Kansas City, MO 64133
Email: jbrown@iaff42.org;dphilbrick@iaff42.org

NOTE: Email address is different than previously reported

2. Date: 05/31/2013

3. FEC Committee ID #: C00365296 This committee is a separate segregated fund. Its connected organization is a Labor Organization

Affiliated Committees/Organizations

Committee ID# C00365296
INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS, LOCAL 42 POLITICAL ACTION COMMITTEE
6320 Manchester Ave.
Suite 42A
Kansas City, Missouri 64133
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Sherwood Smith
6320 Manchester Ave.
Suite 42A
Kansas City,, MO 64133
Title: Treasurer
Phone # (816) 358-4222

Treasurer:

Sherwood Smith
6320 Manchester Ave.
Suite 42A
Kansas City,, Missouri 64133
Title: Treasurer
Phone # (816) 358-4222

Designated Agent(s):

Banks or Depositories

Brotherhood Bank and Trust
756 Minnesota Ave.
Kansas City, Missouri 64133

Signed: Sherwood Smith
Date Signed: 05/31/2013

(End FEC FORM 1)

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