FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-1122048
1. UCB, INC. POLITICAL ACTION COMMITTEE
28 LIBERTY SHIP WAY, SUITE 2815SAUSALITO, CA 94965
NOTE: Address is different than previously reported
Email: reporting@politicomlaw.comNOTE: Email address is different than previously reported
2. Date: 11/01/2016
3. FEC Committee ID #: C00571141 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
UCB, INC.1950 LAKE PARK DRIVE
SMYRNA, Georgia 30080
Affiliated Relationship Code: Connected Organization
Custodian of Records:
JENNIE UNGER SKELTON28 LIBERTY SHIP WAY, SUITE 2815
SAUSALITO, CA 94965
Title: Custodian of Records
Phone # (415) 903-2800
Treasurer:
JENNIE UNGER SKELTON28 LIBERTY SHIP WAY, SUITE 2815
SAUSALITO, California 94965
Title: Treasurer
Phone # (415) 903-2800
Designated Agent(s):
ERIN LAMA28 LIBERTY SHIP WAY, SUITE 2815
SAUSALITO, California 94965
Title: Assistant Treasurer
Phone # (415) 903-2800
Banks or Depositories
BANK OF MARIN2656 BRIDGEWAY, SUITE D
SAUSALITO, California 94965