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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-403697

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1. FLORIDA HEALTH POLITICAL ACTION COMMITTEE

    P.O. Box 6936
    Jacksonville, FL 32236
    Fax: 9049975393
    Email: deborah.easterling-charles@bcbsfl.com

2. Date: 12/16/2008

3. FEC Committee ID #: C00161141 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Suzanne Horne
12876 Plummer Grant Rd.
Jacksonville, FL 32258
Title: President
Phone # (904) 905-8720

Treasurer:

Mr. Gary M. Healy
285 Odoms Mill Blvd
Ponte Vedra Beach, Florida 32082
Title: Treasurer
Phone # (904) 905-4420

Designated Agent(s):

Banks or Depositories

Bank of America
9000 Southside Boulevard
Jacksonville, Florida 32256

Signed: Mr. Gary M. Healy
Date Signed: 02/16/2009
Official Committee FAX: 9049975393

(End FEC FORM 1)

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