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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1216113

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1. Grassroots Victory

    203 S. Union St
    Ste 300
    Alexandria, VA 22314
    Email: notices@feccr.com

2. Date: 03/28/2018

3. FEC Committee ID #: C00674572

This committee is a political committee with both contribution and non-contribution accounts (Hybrid PAC).

Affiliated Committees/Organizations

Committee ID# C00583617
Grassroots Victory
203 S. Union St
Ste 300
Alexandria, Virginia 22314
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Dan Backer
203 S. Union St
Ste 300
Alexandria, VA 22314
Title: Treasurer

Treasurer:

Dan Backer
203 S. Union St
Ste 300
Alexandria, Virginia 22314
Title: Treasurer

Designated Agent(s):

Karl Melton
500 Montgomery St
Ste 400
Alexandria, Virginia 22314
Title: Assistant Treasurer

Banks or Depositories

Access National Bank
4221 Walney Rd
Ste 120
Chantilly, Virginia 20151

Signed: Dan Backer
Date Signed: 03/28/2018

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(End FEC FORM 1)

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