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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-137668

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1. Mike PAC

    P.O. Box 65796
    Washington, DC 20035
    Fax: 2027831918
    Email: vllands@aol.com

2. Date: 10/11/2004

3. FEC Committee ID #: C00383422

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

Committee ID# C00405126
SPRINGFIELD REPUBLICAN EVENT 2004
1111 14TH STREET NW SUITE 1100
WASHINGTON, DC 20005
Relationship: Joint Fundraising

Custodian of Records:

Mark Valente III
P.O. Box 65796
Washington, DC 20035
Title: Treasurer
Phone # (202) 783-1980

Treasurer:

Mark Valente III
P.O. Box 65796
Washington, DC 20035
Title: Treasurer
Phone # (202) 783-1980

Designated Agent(s):

Banks or Depositories

National City Bank
2177 Auburn Road
Shelby Township, Michigan 48317

Signed: Mark Valente III
Date Signed: 10/11/2004
Official Committee FAX: 2027831918

(End FEC FORM 1)

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