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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-721796

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1. AAPA PAC

    2318 Mill Road
    Suite 1300
    Alexandria, VA 22314

    NOTE: Address is different than previously reported

    Email: pac@aapa.org

    NOTE: Email address is different than previously reported

2. Date: 03/13/1980

3. FEC Committee ID #: C00122499 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

American Academy of Physician Assistants
2318 Mill Road
Suite 1300
Alexandria, Virginia 22314
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Gerardo Luna, CPA
2318 Mill Road
Suite 1300
Alexandria, VA 22314
Title: VP, Finance
Phone # (571) 319-4518

Treasurer:

Beverly A Kimball, PA-C
2856 Long Lake Road
Webb Lake, Wisconsin 54830
Title: Treasurer
Phone # (715) 259-7250

Designated Agent(s):

Banks or Depositories

Bank of America
730 15th Street NW
Washington, DC 20005

Signed: Beverly A Kimball, PA-C
Date Signed: 04/11/2011

(End FEC FORM 1)

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