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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1027175

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1. SureID, Inc. Political Action Committee

    NOTE:Commmittee Name is different than previously reported

    5800 NW Pinefarm Place
    Hillsboro, OR 97124
    Email: mpierce@sureid.com;accounting@sureid.com

    NOTE: Email address is different than previously reported

2. Date: 10/08/2015

3. FEC Committee ID #: C00433797 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

SureID, Inc.
5800 NW Pinefarm Place
Hillsboro, Oregon 97124
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Matthew Wayne Pierce
680 SW 136th Ave
Beaverton, OR 97005
Title: Treasurer
Phone # (503) 924-5348

Treasurer:

Matthew Wayne Pierce
680 SW 136th Ave
Beaverton, Oregon 97005
Title: Treasurer
Phone # (503) 924-5348

Designated Agent(s):

Banks or Depositories

Wells Fargo Bank
9900 Southwest Greenburg Rd
Suite 110 MAC p6148-011
Tigard, Oregon 97223

Signed: Matthew Wayne Pierce
Date Signed: 10/08/2015
Official Committee URL: www.sureid.com

NOTE: URL is different than previously reported

(End FEC FORM 1)

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