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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-760572

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1. Democratic Headquarters of the West San Gabriel Valley

    11826 The Wye St.
    El Monte, CA 91732
    Email: jholtzhln@aol.com

    NOTE: Email address is different than previously reported

2. Date: 01/28/2012

3. FEC Committee ID #: C00406488

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:

Joan Holtz
11826 The Wye St.
El Monte, CA 91732
Title: Custodian of Records
Phone # (562) 983-0815

Treasurer:

Joan Holtz
11826 The Wye St.
El Monte, California 91732
Title: Treasurer
Phone # (562) 983-0815

Designated Agent(s):

Gary Crummitt
110 Pine Ave., #1010
Long Beach, California 90802
Title: Assistant Treasurer
Phone # (562) 983-0815

Banks or Depositories

Wells Fargo Bank
3536 Peck Rd.
El Monte, California 91731

Signed: Joan Holtz
Date Signed: 01/28/2012

(End FEC FORM 1)

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