1.Name of organization

2.Date Oganization founded

3.IRS status Non-Profit For-Profit

4.Public Disclosure Commission Reporting Yes No

5.Total Members

6.Is Organization Statewide National Local

7.Organization infrastructure:

Officers

title

title

title

Key committees

Paid staff

Executive Secretarial Legal Legislative Other

Annual Budget

Income Expenditures

Source of income dues events other

Political Action Committee state national local

Number of members

Average contribution $

Total funds collected annually $

A. Key issues

1) 2) 3)

B. Priority arenas State Legislature City/County State Agencies Congress Other

C. Issues are Traditional Brewing Critical

D. We need New law Amendments Reconnaissance Rules/Reg Changes

Monitoring Defense Other

E. We are involved in campaigns involving Issues People

F. We want Phone/Fax tree Newsletter

Please specify

10.Other pertinent information