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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-121901

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1. ActBlue

    P.O. Box 382110
    Cambridge, MA 02238

    NOTE: Address is different than previously reported

    Email: contact@actblue.com

2. Date: 06/04/2004

3. FEC Committee ID #: C00401224

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

-
, ____
Relationship: None

Custodian of Records:

Matthew DeBergalis
P.O. Box 382110
Cambridge, MA 02238
Title: Treasurer

Treasurer:

Matthew DeBergalis
P.O. Box 382110
Cambridge, Massachusetts 02238
Title: Treasurer

Designated Agent(s):

Benjamin Rahn
P.O. Box 382110
Cambridge, Massachusetts 02238
Title: Assistant Treasurer

Banks or Depositories

Wells Fargo
464 California Street
San Francisco, California 94163

Signed: Matthew DeBergalis
Date Signed: 06/04/2004
Official Committee URL: www.ActBlue.com

(End FEC FORM 1)

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