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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-747509

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1. MAVERICK PAC USA

    200 Concord Plaza
    Suite 425
    San Antonio, TX 78216
    Email: mvaneman@kingsommer.com

    NOTE: Email address is different than previously reported

2. Date: 10/12/2011

3. FEC Committee ID #: C00427435

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:

Murray H. Van Eman
200 Concord Plaza
Suite 425
San Antonio, TX 78216
Title: Attorney
Phone # (210) 547-7400

Treasurer:

Murray H. Van Eman
200 Concord Plaza
Suite 425
San Antonio, Texas 78216
Title: Attorney
Phone # (210) 547-7400

Designated Agent(s):

Banks or Depositories

Wells Fargo Bank Texas
1000 Louisiana
2nd Floor
Houston, Texas 77002

Paypal, Inc.
2211 North First Street

San Jose, California 95131

Signed: Murray H. Van Eman
Date Signed: 10/12/2011
Official Committee URL: www.maverickpac.com

(End FEC FORM 1)

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