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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-813904

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1. HERITAGE PALMS DEMOCRATS

    80-170 ROYAL BIRKDALE DR.
    INDIO, CA 92201
    Email: xavier@xmartineztax.com

    NOTE: Email address is different than previously reported

2. Date: 10/09/2012

3. FEC Committee ID #: C00459867

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:

Mitchell Goldstein
80-170 Royal Birkdale Drive
Indio, CA 92201
Title: Treasurer
Phone # (760) 752-1610

Treasurer:

Mitchell Goldstein
80-170 Royal Birkdale Drive
Indio, California 92201
Title: Treasurer
Phone # (760) 752-1610

Designated Agent(s):

Xavier Martinez
1531 Grand Avenue
Suite D
San Marcos, California 92078
Title: Agent
Phone # (760) 752-1610

Banks or Depositories

US Bank
78435 Hwy 111
La Quinta, California 92253

Signed: Mitchell Goldstein
Date Signed: 10/09/2012

(End FEC FORM 1)

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