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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1102912

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1. MALIBU DEMOCRATIC CLUB

    PO BOX 561
    MALIBU, CA 90265

    NOTE: Address is different than previously reported

    Email: lancesimmens@verizon.net;dougrosen@charter.net

    NOTE: Email address is different than previously reported

2. Date: 10/06/2016

3. FEC Committee ID #: C00405795

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

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Doug Rosen
479 Cold Canyon Rd.
Monte Nido, CA 91302
Title: Treasurer
Phone # (310) 600-6893

Treasurer:

Doug Rosen
479 Cold Canyon Rd.
Monte Nido, California 91302
Title: Treasurer
Phone # (310) 600-6893

Designated Agent(s):

Lance Simmons
19130 Pacific Coast Hwy
Malibu, California 90265
Title: President
Phone # (717) 557-4874

Banks or Depositories

Bank of America
P.O. Box 25118
Tampa, Florida 336225118

Signed: Doug Rosen
Date Signed: 10/06/2016
Official Committee URL: www.malibudemocraticclub.org

(End FEC FORM 1)

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