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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-760585

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1. 47th Assembly District Democratic Club

    P.O. Box 4656
    Culver City, CA 90231
    Email: gary@crummittandassociates.com

    NOTE: Email address is different than previously reported

2. Date: 01/28/2012

3. FEC Committee ID #: C00439299

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:

Gwendolyn Austin
P.O. Box 4656
Culver City, CA 90231
Title: Custodian of Records
Phone # (323) 692-0669

Treasurer:

Gwendolyn Austin
P.O. Box 4656
Culver City, California 90231
Title: Treasurer
Phone # (323) 692-0669

Designated Agent(s):

Gary Crummitt
110 Pine Ave., #1010
Long Beach, California 90802
Title: Assistant Treasurer
Phone # (562) 983-0815

Banks or Depositories

Citibank
P.O. Box 226526
Dallas, Texas 75260

Signed: Gwen Austin
Date Signed: 01/28/2012

(End FEC FORM 1)

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