FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-174161
1. COOPERATIVE OF AMERICAN PHYSICIANS-MUTUAL PROTECTION TRUST(CAP-MPT)FEDERAL PAC
NOTE:Commmittee Name is different than previously reported
333 South Hope Street8th Floor
Los Angeles, CA 90071
2. Date: 05/16/2005
3. FEC Committee ID #: C00161604 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Cooperative of American Physicians-Mutual Protection Trust333 South Hope
8th Floor
Los Angeles, California 90071
Relationship: Sponsor
Organization Type: Membership Organization
Custodian of Records:
Cindy Lesonsky333 South Hope Street
8th Floor
Los Angeles, CA 90071
Title: Assistant Treasurer
Treasurer:
Vincent Gualtieri, MD333 South Hope Street
8th Floor
Los Angeles, California 90071
Title: Treasurer
Designated Agent(s):
Cindy Lesonsky333 South Hope Street
8th Floor
Los Angeles, California 90071
Title: Assistant Treasurer
Banks or Depositories
Wells Fargo Bank3550 Wilshire Blvd.
Los Angeles, California 90010