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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1090220

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1. National Association of Rehabilitation Providers & Agencies Inc. Political Action Committee

    625 Walnut Street
    McKeesport, PA 15132

    NOTE: Address is different than previously reported

    Email: mklesher@wms-jen.com

2. Date: 07/18/2016

3. FEC Committee ID #: C00192153 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Nat'lAssoc.ofRehabilitationProviders&Agencies,Inc.
701 8th Street NW
Suite 500
Washington, DC 20001
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Meredith Lesher
701 8th Street, NW
Suite 500
Washington, DC 20001
Phone # (202) 659-8201

Treasurer:

Mark Sulecki
625 Walnut Street
McKeesport, Pennsylvania 15132
Title: Treasurer

Designated Agent(s):

Meredith Lesher
701 8th Street, NW
Suite 500
Washington, DC 20001
Title: Asst. Treasurer
Phone # (202) 659-8201

Banks or Depositories

Chain Bridge Bank
1445-A Laughlin Avenue
McLean, Virginia 22101

Signed: Mark Sulecki
Date Signed: 07/18/2016

(End FEC FORM 1)

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