FEC Form 1 for VHA Inc., Political Action CommitteeForm 1 for VHA Inc., Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-408324

1. VHA Inc., Political Action Committee

901 New York Avenue, N.W.
Suite 510 East
Washington, DC 20001
Email: scarruth@vha.com

2. Date: 03/19/2009

3. FEC Committee ID #: C00199497 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

VHA Inc.
220 East Las Colinas Blvd.
Irving, Texas 75039
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Edward Goodman
901 New York Avenue, N.W.
Suite 510 East
Washington, DC 20001
Title: Vice President
Phone # (202) 354-2607

Treasurer:

Edward Goodman
901 New York Avenue, N.W.
Suite 510 East
Washington, DC 20001
Title: Vice President
Phone # (202) 354-2607

Designated Agent(s):

Cidette Perrin
901 New York Avenue, NW
Suite 510 East
Washington, DC 20001
Title: Director
Phone # (202) 354-2608

Banks or Depositories

The Northern Trust Company
P.O. Box 92000
Chicago, Illinois 606752000

Signed: Edward Goodman
Date Signed: 03/19/2009

(End FEC FORM 1)

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