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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-105392

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1. HOSTS Corporation Champions for Children Fund

    222 NE Park Plaza Drive
    Suite 230
    Vancouver, WA 986843402

    NOTE: Address is different than previously reported

    Email: cfs@pass1.com

2. Date: 01/28/2004

3. FEC Committee ID #: C00369496 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

HOSTS Corporation
222 NE Park Plaza Drive
Suite 230
Vancouver, Washington 986843402
Relationship: Connected
Organization Type: Corporation

Custodian of Records:

Ryan McClintock
c/o PASS
1020 North Fairfax Street
Alexandria, VA 22314
Title: Custodian of Records
Phone # (360) 258-2206

Treasurer:

Ryan McClintock
222 NE Park Plaza Drive
Suite 230
Vancouver, Washington 986843402
Title: Treasurer
Phone # (360) 258-2206

Designated Agent(s):

Banks or Depositories

Capitol National Bank
200 Washington Square North
Lansing, Michigan 48933

Signed: Ryan McClintock
Date Signed: 01/26/2004
Official Committee URL: n/a

(End FEC FORM 1)

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