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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-888045

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1. Wellstone Democratic Renewal Club - PAC

    1737 Allston Way
    Berkeley, CA 94703

    NOTE: Address is different than previously reported

    Email: jack.kurzweil@gmail.com;richard.tamm@gmail.com

    NOTE: Email address is different than previously reported

2. Date: 07/23/2013

3. FEC Committee ID #: C00404525 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

Wellstone Democratic Renewal Club
PO Box 65
Berkeley, California 947010065
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Jack Kurzweil
1737 Allston Way
Berkeley, CA 94703
Title: Treasurer
Phone # (510) 548-7645

Treasurer:

Jack Kurzweil
1737 Allston Way
Berkeley, California 94703
Title: Treasurer
Phone # (510) 548-7645

Designated Agent(s):

Richard Tamm
1015 Shattuck Avenue
Berkeley, California 94707
Title: Asst. Treasurer
Phone # (510) 524-4608

Banks or Depositories

Wells Fargo Bank
2144 Shattuck Avenue
Berkeley, California 94704

Signed: Dan Barki
Date Signed: 09/17/2013
Official Committee URL: wellstoneclub.org

(End FEC FORM 1)

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