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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1034580

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1. Clean PAC

    P.O. Box 151563
    San Rafael, CA 94915
    Email: stacy@hlgcpa.com

2. Date: 12/01/2015

3. FEC Committee ID #: C00564260

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

Jared Huffman
P.O. Box 151563
San Rafael, California 94915
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

Stacy E. Owens
5940 College Avenue
Oakland, CA 94618
Title: Custodian of Records
Phone # (510) 652-1000

Treasurer:

Stacy E. Owens
5940 College Avenue
Oakland, California 94618
Title: Treasurer
Phone # (510) 652-1000

Designated Agent(s):

Anthony Barr
5940 College Avenue
Oakland, California 94618
Title: Assistant Treasurer
Phone # (510) 652-1000

Banks or Depositories

First Republic Bank
1099 4th Street
San Rafael, California 94901

Signed: Stacy Owens
Date Signed: 12/01/2015

FORM TEXT-1

(End FEC FORM 1)

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