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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1626065

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1. American Association of Nurse Anesthetists Separate Segregated Fund (CRNA-PAC)

    10275 W. Higgins Rd
    Suite 500 - c/o Finance Department
    Rosement, IL 60018
    Email: crnapacfec@aanadc.com

2. Date: 08/19/2022

3. FEC Committee ID #: C00173153 This committee is a separate segregated fund. Its connected organization is a Membership Organization
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

American Association of Nurse Anesthetists
10275 W. Higgins Rd
Suite 500
Park Ridge, Illinois 60018
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Eric Graunke
10275 W. Higgins Rd
Suite 500
Rosemont, IL 60018
Title: Controller

Treasurer:

Dr. Lorraine Jordan
10275 W higgins RD
Suite 500
Rosemont, Illinois 60018
Title: Chief Advocacy Offic
Phone # (847) 655-1172

Designated Agent(s):

Catharine Harris
25 Massachusetts Ave NW
Suite 320
Washington, DC 20002
Title: Director of Politica
Phone # (202) 741-9087

Catharine Harris
25 Massachusetts Ave NW
Suite 320
Washington, DC 20002
Title: Director of Politica
Phone # (202) 741-9087

Banks or Depositories

MB Financial
6111 North River Road
Rosemont, Illinois 60018

Signed: Dr. Lorraine Jordan
Date Signed: 08/19/2022

(End FEC FORM 1)

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