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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-485582

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1. CLUB FOR GROWTH PAC

    2001 L ST NW SUITE 600
    WASHINGTON, DC 20036
    Email: arozansky@clubforgrowth.org

2. Date: 08/03/2010

3. FEC Committee ID #: C00432260 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

Club for Growth
2001 L St., NW, Ste. 600
Washington, DC 20036
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Adam Rozansky
2001 L St., NW, Ste. 600
Washington, DC 20036
Title: Treasurer
Phone # (202) 955-5500

Treasurer:

Adam Rozansky
2001 L St., NW, Ste. 600
Washington, DC 20036
Title: Treasurer
Phone # (202) 955-5500

Designated Agent(s):

Banks or Depositories

SunTrust Bank
1445 New York Ave., NW
Washington, DC 20005

Signed: Adam Rozansky
Date Signed: 08/03/2010

(End FEC FORM 1)

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