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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1057771

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1. National Seating & Mobility Inc Political Action Committee

    320 Premier Ct S
    Suite 220
    Franklin, TN 37067
    Email: ryan.peebles@nsm-seating.com

2. Date: 03/28/2016

3. FEC Committee ID #: C00613422 This committee is a separate segregated fund. Its connected organization is a Corporation W/O Capital Stock

Affiliated Committees/Organizations

National Seating & Mobility Inc
320 Premier Ct S
Suite 220
Franklin, Tennessee 37067
Affiliated Relationship Code: Connected Organization

Custodian of Records:

William Ryan Peebles
320 Premier Ct
suite 220
Franklin, TN 37067

Treasurer:

William Ryan Peebles
320 Premier Ct S
Suite 220
Franklin, Tennessee 37067

Designated Agent(s):

Deborah Wade
320 Preimer Ct
suite 220
Franklin, Tennessee 37067

Banks or Depositories

TBD
TBD
Franklin, Tennessee 37067

Signed: William Ryan Peebles
Date Signed: 03/31/2016

(End FEC FORM 1)

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