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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-883352

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1. Conservative Action Fund

    717 King Street
    STE 300
    Alexandria, VA 22314

    NOTE: Address is different than previously reported

    Email: dbacker@dbcapitolstrategies.com

2. Date: 07/31/2013

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.
717 King Street
STE 300
Alexandria, VA 22314
Title: Treasurer
Phone # (202) 210-5431

Treasurer:

Dan Backer, Esq.
717 King Street
STE 300
Alexandria, Virginia 22314
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: 07/31/2013
Official Committee URL: www.ConservativeActionFund.com

FORM TEXT

(End FEC FORM 1)

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