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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-744575

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1. AMERICAN TELESERVICES ASSOCIATION PAC

    3815 RIVER CROSSING PKWY SUITE 20
    INDIANAPOLIS, IN 46240
    Email: bobkobek@ataconnect.org

    NOTE: Email address is different than previously reported

2. Date: 08/04/2011

3. FEC Committee ID #: C00397083 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

American Teleservices Association
3815 River Crossing Parkway
Ste 20
Indianapolis, Indiana 46240
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Robert Kobek
3815 River Crossing Parkway
Suite 20
Indianapolis, IN 46240

Treasurer:

Robert Kobek
3815 River Crossing Parkway
Suite 20
Indianapolis, Indiana 46240
Title: Interim President
Phone # (317) 816-9336

Designated Agent(s):

Banks or Depositories

CHASE
8630 Keystone Xing
Indianapolis, Indiana 46240

Signed: Robert Kobek
Date Signed: 09/13/2011

(End FEC FORM 1)

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