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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-715969

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1. The Leadership Circle PAC

    PO Box 97275
    Raleigh, NC 27624

    NOTE: Address is different than previously reported

    Email: TLC@cmandco.com

    NOTE: Email address is different than previously reported

2. Date: 01/20/2004

3. FEC Committee ID #: C00394916

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

Affiliated Committees/Organizations

Custodian of Records:

Collin A. McMichael
PO Box 97275
Raleigh, NC 27624
Title: Assistant Treasurer
Phone # (919) 833-3551

Treasurer:

William James Black, Jr.
PO Box 97275
Raleigh, North Carolina 27624
Title: Treasurer
Phone # (919) 833-3551

Designated Agent(s):

Collin A. McMichael
PO Box 97275
Raleigh, North Carolina 27624
Title: Assistant Treasurer
Phone # (919) 833-3551

Banks or Depositories

First Citizens Bank
239 Fayetteville St Mall
Raleigh, North Carolina 27601

Signed: Collin McMichael, Asst. Treasurer
Date Signed: 02/28/2011
Official Committee URL: www.theleadershipcircle.org

(End FEC FORM 1)

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