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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-793635

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1. Michigan First PAC

    901 N Washington Street
    Suite 700
    Alexandria, VA 223141535

    NOTE: Address is different than previously reported

    Email: ted@kochandhoos.com

2. Date: 07/07/2012

3. FEC Committee ID #: C00495317

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
     In addition, this committee is a Leadership PAC.

Affiliated Committees/Organizations

Candidate ID# H0MI01088
Dr. Daniel J. Benishek
802 Pentoga Trail
Crystal Falls, Michigan 49920
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

Theodore V. Koch
901 N Washington Street
Suite 700
Alexandria, VA 223141535
Title: Treasurer
Phone # (703) 299-8570

Treasurer:

Theodore V. Koch
901 N Washington Street
Suite 700
Alexandria, Virginia 223141535
Title: Treasurer
Phone # (703) 299-8570

Designated Agent(s):

Timothy A. Koch
901 N Washington Street
Suite 700
Alexandria, Virginia 223141535
Title: Assistant Treasurer
Phone # (703) 299-8571

Banks or Depositories

PNC Bank
825 N Washington Street
Alexandria, Virginia 22314

Signed: Theodore V. Koch
Date Signed: 07/07/2012

(End FEC FORM 1)

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