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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1572881

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1. PATRIOTS PAC LLC

    2275 MARIETTA BLVD
    SUITE 270-312
    ATLANTA, GA 30318
    Email: Treasurer@takebackga.com;Admin@takebackga.com

2. Date: 02/28/2022

3. FEC Committee ID #: C00807958 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

PATRIOTS PAC LLC
2275 MARIETTA BLVD
STE 270-312
ATLANTA, Georgia 30318
Affiliated Relationship Code: Connected Organization

Custodian of Records:

MELVIN JOHNSON
1878 Harrison Ct NE
Atlanta, GA 30329
Title: Treasurer
Phone # (404) 680-2303

Treasurer:

MELVIN JOHNSON, JOHNSON
1878 Harrison Ct NE
Atlanta, Georgia 30329
Phone # (404) 680-2303

Designated Agent(s):

Banks or Depositories

JP MORGAN CHASE BANK
5768 BUFORD HWY NE
DORAVILLE, Georgia 30340

Signed: MELVIN JOHNSON, JOHNSON
Date Signed: 03/08/2022

(End FEC FORM 1)

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