FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-756788
1. AX PAC
1006 PENDLETON STREETALEXANDRIA, VA 22314
Email: kevin@bsbsolutions.net
2. Date: 01/06/2012
3. FEC Committee ID #: C00506535This 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# H0WI07051
SEAN DUFFY
2906 CITY HEIGHTS ROAD
ASHLAND, Wisconsin 54806
Affiliated Relationship Code: Leadership PAC Sponsor
Custodian of Records:
Mr. Kevin Jahns
1006 Pendleton Street
Alexandria, VA 22314
Title: Treasurer
Treasurer:
Mr. Kevin Jahns
1006 Pendleton Street
Alexandria, Virginia 22314
Title: Treasurer
Phone # (703) 683-6703
Designated Agent(s):
Banks or Depositories
Burke & Herbert Bank & Trust Company
306 E. Monroe Ave.
Alexandria, Virginia 22301
Signed: Mr. Kevin Jahns
Date Signed: 01/09/2012
(End FEC FORM 1)
Date Signed: 01/09/2012