FEC Form 1 for GROWTH ENERGY PACForm 1 for GROWTH ENERGY PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1093697

1. GROWTH ENERGY PAC

777 N CAPITOL ST NE, SUITE 805
WASHINGTON, DC 20002
Email: PAC@GROWTHENERGY.ORG

2. Date: 08/12/2016

3. FEC Committee ID #: C00475665 This committee is a separate segregated fund. Its connected organization is a Trade Association
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Growth Energy
777 N. Capitol St NE, Suite 805
Washington, DC 20002
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Benjamin Butterfield
777 N. Capitol St NE, Suite 805
Washington, DC 20002
Title: Treasurer
Phone # (202) 545-4000

Treasurer:

Benjamin Butterfield
777 N. Capitol St NE, Suite 805
Washington, DC 20002
Title: Treasurer
Phone # (202) 545-4000

Designated Agent(s):

John Fuher
777 N. Capitol St NE, Suite 805
Washington, DC 20002
Title: Assistant Treasurer
Phone # (202) 545-4000

Banks or Depositories

First National Bank of Omaha
1620 Dodge Street
Omaha, Nebraska 68197

Signed: Benjamin Butterfield
Date Signed: 08/12/2016

FORM TEXT-1

(End FEC FORM 1)

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