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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-950317

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1. International Union of Operating Engineers Local 841 PAC

    6801 South U.S. 41
    P.O. Box 2157
    Terre Haute, IN 47802
    Email: tridge@iuoelocal841.com;jfisher@sackrider.com

    NOTE: Email address is different than previously reported

2. Date: 01/30/2009

3. FEC Committee ID #: C00458794 This committee is a separate segregated fund. Its connected organization is a Labor Organization

Affiliated Committees/Organizations

International Union of Operating Engineers Political Education Committee
1125 Seventeenth Street Northwest
Washington, DC 20036
Affiliated Relationship Code: Affiliated Committee

International Union of Operating Engin
PO Box 2157
Terre Haute, Indiana 47802
Affiliated Relationship Code: Connected Organization

Custodian of Records:

John Moore
6801 South U.S. 41
Terre Haute, IN 47802
Title: Recording & Corr Sec
Phone # (812) 299-1177

Treasurer:

Tom Ridge
6801 South U.S. 41
Terre Haute, Indiana 47802
Title: Treasurer
Phone # (812) 299-1177

Designated Agent(s):

Mark Spires
PO Box 2157
Terre Haute, Indiana 47802
Title: Assistant Treasurer
Phone # (812) 299-1177

Banks or Depositories

First Financial Bank
One First Financial Plaza
Terre Haute, Indiana 47807

Signed: Tom Ridge
Date Signed: 09/10/2014

(End FEC FORM 1)

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