FEC Form 1 for CA Hospital Association PAC-Fed Spons by CA Assn of Hospitals & Health Systems (CAHHS)Form 1 for CA Hospital Association PAC-Fed Spons by CA Assn of Hospitals & Health Systems (CAHHS)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-714537

1. CA Hospital Association PAC-Fed Spons by CA Assn of Hospitals & Health Systems (CAHHS)

1215 K Street, Suite 800
Sacramento, CA 95814
Email: feccomm@bmhlaw.com

NOTE: Email address is different than previously reported

2. Date: 02/15/2011

3. FEC Committee ID #: C00237495 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

American Hospital Association Political Action Committee
325 Seventh Street, N.W.
Washington, DC 20004
Affiliated Relationship Code: Affiliated Committee

California Association of Hospitals &
1215 K Street, Suite 800
Sacramento, California 95814
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Thomas W. Hiltachk
455 Capitol Mall, Suite 600
Sacramento, CA 95814
Title: Custodian of Records
Phone # (916) 442-7757

Treasurer:

Thomas W. Hiltachk
455 Capitol Mall, Suite 600
Sacramento, California 95814
Title: Treasurer
Phone # (916) 442-7757

Designated Agent(s):

Charles H. Bell
455 Capitol Mall, Suite 600
Sacramento, California 95814
Title: Assistant Treasurer
Phone # (916) 442-7757

Banks or Depositories

California Bank & Trust
550 South Hope Street, Suite 100
Los Angeles, California 90071

Signed: Thomas W. Hiltachk
Date Signed: 02/15/2011

FORM TEXT

(End FEC FORM 1)

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