FEC Form 1 for American Academy of Ophthalmology Inc Political Committee (OPHTHPAC)Form 1 for American Academy of Ophthalmology Inc Political Committee (OPHTHPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-446487

1. American Academy of Ophthalmology Inc Political Committee (OPHTHPAC)

655 Beach Street
San Francisco, CA 94109
Email: srausch@aao.org

2. Date: 01/22/2010

3. FEC Committee ID #: C00196246 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 Academy of Ophthalmology
655 Beach Street
San Francisco, California 94109
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Steven Rausch
c/o AAO 655 Beach Street
San Francisco, California 94109
Title: Treasurer
Phone # (415) 561-8500

Designated Agent(s):

Banks or Depositories

Bank of America
101 S Marengo Avenue
3rd Floor
Pasadena, California 91101

Wells Fargo Bank N.A.
PO Box 63020

San Francisco, California 94163

Signed: Steven Rausch
Date Signed: 01/22/2010

(End FEC FORM 1)

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