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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-855183

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1. Conservative Action Fund

    209 Pennsylvania Avenue SE
    Suite 2109
    Washington, DC 20003

    NOTE: Address is different than previously reported

    Email: dbacker@dbcapitolstrategies.com

2. Date: 02/12/2013

3. FEC Committee ID #: C00496505

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:

Dan Backer, Esq.
209 Pennsylvania Avenue SE
Suite 2109
Washington, DC 20003
Title: Treasurer
Phone # (202) 210-5431

Treasurer:

Dan Backer, Esq.
209 Pennsylvania Avenue SE
Suite 2109
Washington, DC 20003
Title: Treasurer
Phone # (202) 210-5431

Designated Agent(s):

Shaun McCutcheon
5011 Lake Crest Circle
Hoover, Alabama 35226
Title: Chairman
Phone # (205) 542-9961

Banks or Depositories

Access National Bank
14006 Lee Jackson Memorial Hwy
Chantilly, Virginia 20151

Signed: Dan Backer, Esq.
Date Signed: 02/12/2013
Official Committee URL: www.ConservativeActionFund.com

FORM TEXT

(End FEC FORM 1)

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