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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-802015

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1. Eid Passport, Inc.

    10450 Sw Nimbus Ave Bldg R-A
    Portland, OR 97223
    Email: mpierce@eidpassport.com;accounting@eidpassport.com

    NOTE: Email address is different than previously reported

2. Date: 07/30/2012

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

Affiliated Committees/Organizations

Committee ID# C00433797
Eid Passport, Inc.
10450 Sw Nimbus Ave Bldg R-A
Portland, Oregon 97223
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: 07/30/2012
Official Committee URL: www.eidpassport.com

(End FEC FORM 1)

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