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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-734849

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1. WEST LOS ANGELES HEALTH PAC - Federal

    3700 Wilshire Blvd Ste 1050B
    Los Angeles, CA 90010

    NOTE: Address is different than previously reported

2. Date: 07/13/2011

3. FEC Committee ID #: C00198861 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

Custodian of Records:

Mr. David Gould
3700 Wilshire Blvd Ste1050B
Los Angeles, CA 90010
Title: Treasurer
Phone # (213) 489-4792

Treasurer:

David Gould
3700 Wilshire Blvd Ste 1050B
Los Angeles, California 90010
Title: Treasurer
Phone # (213) 489-4792

Designated Agent(s):

Ms. Michelle Moore-Sanders
3700 Wilshire Blvd Ste 1050B
Los Angeles, California 90010
Title: Assistant Treasurer
Phone # (213) 489-4792

Banks or Depositories

California Bank & Trust
550 S Hope St Ste 100
Los Angeles, California 90071

Signed: David Gould
Date Signed: 07/13/2011

(End FEC FORM 1)

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