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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-100377

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1. National Community Pharmacists Association - PAC

    205 Daingerfield Road
    Alexandria, VA 223142885

2. Date: 11/20/2003

3. FEC Committee ID #: C00030809 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Mr. John Rector
205 Daingerfield Road
Alexandria, Virginia 22314
Title: Treasurer
Phone # (301) 683-8200

Designated Agent(s):

Banks or Depositories

Signed: Mr. John Rector
Date Signed: 11/20/2003

(End FEC FORM 1)

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