FEC Form 1 for Grassroots Oregon VotersForm 1 for Grassroots Oregon Voters

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1256096

1. Grassroots Oregon Voters

3681 Windgate Street
Medford, OR 97504
Email: jzccpa@sonic.net;kdmoline@gmail.com

2. Date: 08/14/2018

3. FEC Committee ID #: C00685388

This committee is an independent expenditure-only political committee (Super PAC).

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Joann Cleckner
3681 Windgate Street
Medford, OR 97504
Title: Treasurer
Phone # (541) 500-8382

Treasurer:

Joann Cleckner
3681 Windgate Street
Medford, Oregon 97504
Title: Treasurer
Phone # (541) 500-8382

Designated Agent(s):

Joann Cleckner
3681 Windgate Street
Medford, Oregon 97504
Phone # (541) 500-8382

Jamex Albert Bachman
943 B Street
Ashland, Oregon 97520
Title: Asst. Treasurer
Phone # (619) 301-1130

Banks or Depositories

Washington Federal
3220 Hillcrest Park Dr.
Medford, Oregon 97504

Signed: Joann Cleckner
Date Signed: 08/14/2018

FORM TEXT-1

(End FEC FORM 1)

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