FEC Form 1 for American Chiropractic Association PACForm 1 for American Chiropractic Association PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-122181

1. American Chiropractic Association PAC

1701 Clarendon Blvd
Arlington, VA 22209
Fax: 0-
Email: kkrocker@amerchiro.org

2. Date: 06/09/2004

3. FEC Committee ID #: C00102764 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

American Chiropractic Association
1701 Clarendon Blvd
Arlington, Virginia 22209
Relationship: Connected Organization
Organization Type: Membership Organization

Custodian of Records:

Phone # 0

Treasurer:

Dr Mario Spoto
1701 Clarendon Blvd
Arlington, Virginia 22204
Phone # (703) 276-8800

Designated Agent(s):

Kim Krocker
1701 Clarendon Blvd
Arlington, Virginia 22209
Title: PAC Manager
Phone # (703) 276-8800

Banks or Depositories

BB&T
Arlington, Virginia 22209

Signed: Dr Mario Spoto
Date Signed: 06/09/2004
Official Committee URL: www.acatoday.com
Official Committee FAX: 0-

(End FEC FORM 1)

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