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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-131469

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1. Vision Council of America Political Action Committee

    1700 Diagonal Road
    Suite 500
    Alexandria, VA 22314
    Fax: 7034258352

2. Date: 08/17/2004

3. FEC Committee ID #: C00372441 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Vision Council of America
1700 Diagonal Road
Suite 500
Alexandria, Virginia 22314
Relationship: Connected
Organization Type: Trade Association

Custodian of Records:

Richard B. Bullwinkle
1700 Diagonal Road
Suite 500
Alexandria, VA 22314
Title: Treasurer
Phone # (703) 548-4560

Treasurer:

Richard B. Bullwinkle
1700 Diagonal Road
Suite 500
Alexandria, Virginia 22314
Title: Treasurer
Phone # (703) 548-4560

Designated Agent(s):

Susan Arceneaux
P.O. Box 373
Fairfax Station, Virginia 22039
Title: Assistant Treasurer
Phone # (703) 250-0496

Banks or Depositories

SunTrust Bank
3013 Duke Street
Alexandria, Virginia 22314

Signed: Richard B. Bullwinkle
Date Signed: 08/17/2004
Official Committee FAX: 7034258352

(End FEC FORM 1)

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