FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-410648
1. America Forward Leadership PAC
1831 Bay Street SEWashington, DC 20003
Email: devans@evanskatz.com
NOTE: Email address is different than previously reported
2. Date: 04/01/2009
3. FEC Committee ID #: C00403675This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
In addition, this committee is a Leadership PAC.
Affiliated Committees/Organizations
Candidate ID# H6MI01028
REP. JOHN CONYERS, JR
8503 Marygrove Drive
Detroit, Michigan 48221
Affiliated Relationship Code: Leadership PAC Sponsor
Custodian of Records:
Diane Evans
1831 Bay Street, SE
Washington, DC 20003
Title: Treasurer
Phone # (202) 548-0880
Treasurer:
Diane Evans
1831 Bay Street, SE
Washington, DC 20003
Title: Treasurer
Phone # (202) 548-0880
Designated Agent(s):
Diane Evans
1831 Bay Street, SE
Washington, DC 20003
Title: Treasurer
Phone # (202) 548-0880
Banks or Depositories
Bank of America
201 Pennsylvania Avenue, SE
Washington, DC 20003
Signed: Diane Evans
Date Signed: 04/01/2009
(End FEC FORM 1)
Date Signed: 04/01/2009