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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1109450

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1. Jackson Offshore Operators PAC Inc.

    1217 MacArthur Ave
    Harvey, LA 70058
    Email: Jharkness@joollc.com

2. Date: 10/17/2016

3. FEC Committee ID #: C00627679 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Jackson Offshore LLC
1217 MacArthur Ave.
Harvey, Louisiana 70058
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Jay Harkness
1217 MacArthur Avenue
1217 MacArthur Avenue, LA 70058

Treasurer:

Gina N. Rachel, CPA
One Galleria Blvd
Suite 2100
Metairie, Louisiana 70001
Title: Treasurer
Phone # (504) 837-5990

Designated Agent(s):

Banks or Depositories

Regions Bank
1749 Manhattan Blvd
Harvey, Louisiana 70058

Signed: Gina N. Rachel, CPA
Date Signed: 10/17/2016

(End FEC FORM 1)

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