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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-707138

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1. National Stonewall Democrats Political Action Committee

    1325 Massachusetts Ave. NW
    # 700
    Washington, DC 20005
    Email: bjacobs@stonewalldemocrats.org

    NOTE: Email address is different than previously reported

2. Date: 01/21/2011

3. FEC Committee ID #: C00375527 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

National Stonewall Democrats
1325 Massachusetts Ave.
#700
Washington, DC 20005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Michael Mitchell
1325 Massachusetts Ave. NW
#700
Washington, DC 20005
Title: Executive Director

Treasurer:

William R Jacobs
2822 Soft Horizon Way
Las Vegas, Nevada 20005
Title: Treasurer
Phone # (702) 239-1536

Designated Agent(s):

Michael Mitchell
1325 Massachusetts Ave. NW
#700
Washington, DC 20005
Title: Executive Director

Banks or Depositories

Bank of America
3 DuPont Circle NW
Washington, DC 20005

Signed: William R Jacobs
Date Signed: 01/21/2011
Official Committee URL: http://www.stonewalldemocrats.org

(End FEC FORM 1)

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