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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-772578

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1. DECLARATION ALLIANCE PAC

    PO BOX 1310
    HERNDON, VA 20172

    NOTE: Address is different than previously reported

    Email: info@declarationalliance.net

    NOTE: Email address is different than previously reported

2. Date: 06/20/2007

3. FEC Committee ID #: C00414888 This committee is a separate segregated fund. Its connected organization is a Corporation W/O Capital Stock

Affiliated Committees/Organizations

DECLARATION ALLIANCE INC
2400 Earlsgate Court
Reston, Virginia 20191
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mary Parker Lewis
4700 Surry Place
Alexandria, VA 22304
Title: Treasurer
Phone # (703) 264-2024

Treasurer:

Mary Parker Lewis
4700 Surry Place
Alexandria, Virginia 22304
Title: Treasurer
Phone # (703) 264-2024

Designated Agent(s):

Mary Parker Lewis
4700 Surry Place
Alexandria, Virginia 22304
Title: Treasurer
Phone # (703) 264-2024

Banks or Depositories

Horizon Capital Bank
3707 Richmond Avenue
Houston, Texas 77046

Signed: Mary Parker Lewis
Date Signed: 03/29/2012
Official Committee URL: www.declarationalliance.net

(End FEC FORM 1)

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