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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-484174

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1. Democracy Engine, Inc., PAC

    NOTE:Commmittee Name is different than previously reported

    2125 14th Street NW #101W
    Washington, DC 20009
    Email: info@democracyenginepac.org

2. Date: 07/22/2010

3. FEC Committee ID #: C00468314 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Democracy Engine, Inc.
2125 14th Street NW #101W
Washington, DC 20009
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Jonathan Zucker
2125 14th Street NW #101W
Washington, DC 20009
Title: Treasurer
Phone # (202) 449-9647

Treasurer:

Jonathan Zucker
2125 14th Street NW #101W
Washington, DC 20009
Title: Treasurer
Phone # (202) 449-9647

Designated Agent(s):

Banks or Depositories

Citi
1775 Pennsylvania Ave, NW
Washington, DC 20006

Signed: Jonathan Zucker
Date Signed: 07/22/2010

(End FEC FORM 1)

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