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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-761814

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1. Keystone PAC

    PO Box 29
    Uwchland, PA 194800029
    Email: mdehaven5@verizon.net

    NOTE: Email address is different than previously reported

2. Date: 07/02/2007

3. FEC Committee ID #: C00436295

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
     In addition, this committee is a Leadership PAC.

Affiliated Committees/Organizations

Jim Gerlach
649 Deep Hollow Lane
Chester Springs, Pennsylvania 194251729
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

Michael DeHaven
PO Box 29
Uwchland, PA 194800029
Title: Treasurer
Phone # (610) 329-1878

Treasurer:

Michael DeHaven
PO Box 29
Uwchland, Pennsylvania 194800029
Title: Treasurer
Phone # (610) 329-1878

Designated Agent(s):

Linda Dexter
19 Meadow Creek Lane
Glenmoore, Pennsylvania 193432017
Title: Assistant Treasurer

Banks or Depositories

Penn Liberty Bank
PO Box 740
Uwchland, Pennsylvania 194800740

Signed: Michael DeHaven
Date Signed: 01/31/2012

(End FEC FORM 1)

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