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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1514754

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1. Tabacalera USA Inc. Political Action Committee

    5900 N. Andrews Avenue, Ste. 600
    Fort Lauderdale, FL 33309
    Email: TUSAPAC@tabacalerausa.com

2. Date: 04/29/2021

3. FEC Committee ID #: C00778183 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Tabacalera USA Inc.
5900 N. Andrews Avenue, Ste. 600
Fort Lauderdale, Florida 33309
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Jacquelyn Gogin
5900 N. Andrews Avenue, Ste. 600
Fort Lauderdale, FL 33309
Title: Treasurer
Phone # (954) 772-9000

Treasurer:

Jacquelyn Gogin
5900 N. Andrews Avenue, Ste. 600
Fort Lauderdale, Florida 33309
Title: Treasurer
Phone # (954) 772-9000

Designated Agent(s):

Wanda Rosella
5900 N. Andrews Avenue, Ste. 600
Fort Lauderdale, Florida 33309
Title: Assistant Treasurer
Phone # (954) 772-9000

Banks or Depositories

FirstBank Florida
800 Waterford Way, Suite 800
Miami, Florida 33126

Signed: Jacquelyn Gogin
Date Signed: 04/29/2021
Official Committee URL: None

(End FEC FORM 1)

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