FEC Form 1 for American Political Action CommitteeForm 1 for American Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-431280

1. American Political Action Committee

PO Box 1682
Bellevue, WA 98009
Email: alangottlieb@aol.com

2. Date: 08/28/2009

3. FEC Committee ID #: C99002396 This committee is an Authorized Committee,
and is NOT a Principal Campaign Committee. Candidate:
Party:
Office Sought:
State is in District:

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Alan M Gottlieb
12500 NE Tenth Place
Bellevue, WA 98005
Title: President
Phone # (425) 454-7009

Treasurer:

J.H. Versnel
12500 NE 10th Place
Bellevue, Washington 98034
Title: Treasurer
Phone # (425) 454-7009

Designated Agent(s):

Banks or Depositories

Signed: J.H. Versnel
Date Signed: 08/28/2009
Official Committee URL: www.ameripac.org

(End FEC FORM 1)

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