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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-743905

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1. NORTH ISLAND CREDIT UNION EMPLOYEES' PAC

    2150 RIVER PLAZA DR. #150
    SACRAMENTO, CA 95833
    Email: BAUER@THEAGENCY.US

    NOTE: Email address is different than previously reported

2. Date: 09/06/2011

3. FEC Committee ID #: C00449694 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

NORTH ISLAND CREDIT UNION
5898 COPLEY DR.
SAN DIEGO, California 92111
Affiliated Relationship Code: Connected Organization

Custodian of Records:

DAVID BAUER
2150 RIVER PLAZA DR. 150
SACRAMENTO, CA 95833
Title: Custodian of Records
Phone # (916) 473-4298

Treasurer:

DAVID BAUER
2150 RIVER PLAZA DR. #150
SACRAMENTO, California 95833
Title: Treasurer
Phone # (916) 473-4298

Designated Agent(s):

None

Banks or Depositories

WELLS FARGO
400 CAPITOL MALL
SACRAMENTO, California 95814

Signed: DAVID BAUER
Date Signed: 09/06/2011

(End FEC FORM 1)

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