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FEC Form 1 for First Data Corporation Employees for Responsible GovernmentForm 1 for First Data Corporation Employees for Responsible Government

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-138039

1. First Data Corporation Employees for Responsible Government

    12500 E. Belford Avenue
    M21A1A
    Englewood, CO 80112
    Fax: 7203320516

2. Date: 10/12/2004

3. FEC Committee ID #: C00394494 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

First Data Corporation
12500 E. Belford Avenue
M21A1A
Englewood, Colorado 80112
Relationship: Connected
Organization Type: Corporation

Custodian of Records:

Joseph Samuel
12500 E. Belford Avenue
M21A1A
Englewood, CO 80112
Title: PAC Treasurer
Phone # (720) 332-5214

Treasurer:

Joseph Samuel
12500 E. Belford Avenue
M21A1A
Englewood, Colorado 80112
Title: PAC Treasurer
Phone # (720) 332-5214

Designated Agent(s):

Tim Daly
12500 E. Belford Avenue
M21A1A
Englewood, Colorado 80112
Title: SVP Gov't Relations
Phone # (720) 332-5222

Banks or Depositories

Wells Fargo
1740 Broadway
C7301-025
Denver, Colorado 80214

Signed: Joseph Samuel
Date Signed: 10/12/2004
Official Committee FAX: 7203320516

(End FEC FORM 1)


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