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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1355710

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1. Take Back the White House

    5429 Madison Avenue
    Sacramento, CA 95841
    Email: campaigns@rcbs.us

2. Date: 10/10/2019

3. FEC Committee ID #: C00722496

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

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Denise Lewis
5429 Madison Avenue
Sacramento, CA 95841
Title: Treasurer
Phone # (916) 348-9100

Treasurer:

Denise Lewis
5429 Madison Avenue
Sacramento, California 95841
Title: Treasurer
Phone # (916) 348-9100

Designated Agent(s):

Banks or Depositories

First Foundation Bank
2233 Douglas Blvd., Suite 300
Roseville, California 95661

Signed: Denise Lewis
Date Signed: 10/10/2019

FORM TEXT-1

(End FEC FORM 1)

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