FEC Form 1 for COASTPACForm 1 for COASTPAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-190778

1. COASTPAC

1939 17th Street NW #12
WASHINGTON, DC 20009
Fax: 2027751796
Email: greg.burns@marloweco.com

2. Date: 10/25/2005

3. FEC Committee ID #: C00395566 This committee is a Principal Campaign Committee. Candidate:
Party: National
Office Sought:
State is in District:

Affiliated Committees/Organizations

Custodian of Records:

Gregory Burns
1939 17th Street NW #12
Washington, DC 20009
Title: Director and Founder
Phone # (202) 390-3204

Treasurer:

Gregory Burns
1939 17th Street NW #12
Washington, DC 20009
Title: Director and Founder
Phone # (202) 390-3204

Designated Agent(s):

Banks or Depositories

Wachovia Bank
Connecticut and L Streets NW
Washington, DC 20036

Signed: Gregory Burns
Date Signed: 10/25/2005
Official Committee FAX: 2027751796

(End FEC FORM 1)

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