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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-759604

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1. Dairymans Federal Political Action Committee

    504 Van Ness Ave
    Fresno, CA 93721
    Email: tbardairy@aol.com

2. Date: 01/25/2012

3. FEC Committee ID #: C00506618

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

Dairymans State Political Action Committee
504 Van Ness Ave
Fresno, California 93721
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Tom Barcellos
504 Van Ness Ave
Fresno, CA 93721
Title: Custodian of Records

Treasurer:

Tom Barcellos
504 Van Ness Ave
Fresno, California 93721
Title: Treasurer

Designated Agent(s):

Banks or Depositories

Security First Bank
663 W Nees
Fresno, California 93711

Signed: Tom Barcellos
Date Signed: 01/25/2012

(End FEC FORM 1)

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