FEC Form 1 for SCOOTER STORE, INC. POLITICAL ACTION COMMITTEE; THEForm 1 for SCOOTER STORE, INC. POLITICAL ACTION COMMITTEE; THE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-812997

1. SCOOTER STORE, INC. POLITICAL ACTION COMMITTEE; THE

1650 INDEPENDENCE DRIVE
NEW BRAUNFELS, TX 78132
Email: tzipp@thescooterstore.com

NOTE: Email address is different than previously reported

2. Date: 10/04/2012

3. FEC Committee ID #: C00419937 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

The SCOOTER Store, Inc.
1650 Independence Drive
New Braunfels, Texas 78132
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Tim Zipp
1650 Independence Drive
New Braunfels, TX 78132
Title: Treasurer
Phone # (830) 627-4403

Treasurer:

Tim Zipp
1650 Independence Drive
New Braunfels, Texas 78132
Title: Treasurer
Phone # (830) 627-4403

Designated Agent(s):

Banks or Depositories

Chase Bank
111 West San Antonio Street
New Braunfels, Texas 78132

Signed: Tim Zipp
Date Signed: 10/04/2012

FORM TEXT

(End FEC FORM 1)

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