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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1702947

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1. CHAMPION AMERICAN VALUES

    PO BOX 2485
    SPRINGFIELD, VA 22152
    Email: CAVPAC2@CONCENTRICOFFICE.COM

2. Date: 05/03/2023

3. FEC Committee ID #: C00770214

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

Affiliated Committees/Organizations

Committee ID# C00460402
KANSAS CAV PAC
PO BOX 2485
SPRINGFIELD, Virginia 221520485
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

SUE CARLIN
8136 OLD KEENE MILL RD
SUITE A300
SPRINGFIELD, VA 22152
Title: ASST. TREASURER
Phone # (703) 569-9481

Treasurer:

ROBERT F. CARLIN
PO BOX 2485
SPRINGFIELD, Virginia 22152
Title: TREASURER
Phone # (703) 569-9400

Designated Agent(s):

Banks or Depositories

EMPRISE BANK
257 N BROADWAY
WICHITA, Kansas 67202

Signed: ROBERT F. CARLIN
Date Signed: 05/03/2023

(End FEC FORM 1)

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