FEC Form 1 for American Family Business Institute Political Action Committee (AFBI PAC)Form 1 for American Family Business Institute Political Action Committee (AFBI PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-409335

1. American Family Business Institute Political Action Committee (AFBI PAC)

1920 L Street, NW
Suite 200
Washington, DC 20036
Email: carrie.simms@nodeathtax.org

2. Date: 03/24/2009

3. FEC Committee ID #: C00453134 This committee is a separate segregated fund. Its connected organization is a Membership Organization
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

American Family Business Institute
1920 L Street, NW
Suite 200
Washington, DC 20036
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Steve Ralls
FEC Financial
PO Box 651374
Potomac Falls, VA 20165
Title: Custodian of Records
Phone # (703) 430-6635

Treasurer:

Carrie E. Simms
1920 L Steet, NW
Suite 200
Washington, DC 20036
Title: Treasurer
Phone # (202) 969-2444

Designated Agent(s):

Howard Segermark
1920 L Street, NW
Washington, DC 20036
Title: Assistant Treasurer

Banks or Depositories

Wachovia Bank
NC 11354
1525 West W.T. Boulevard
Charlotte, North Carolina 282881135

Signed: Carrie E. Simms
Date Signed: 03/24/2009

(End FEC FORM 1)

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