FEC Form 1 for American Society of Anesthesiologists Political Action CommitteeForm 1 for American Society of Anesthesiologists Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1183262

1. American Society of Anesthesiologists Political Action Committee

1061 American Lane
Schaumburg, IL 60173
Email: n.matus@asahq.org;m.grassi@asahq.org

NOTE: Email address is different than previously reported

2. Date: 09/21/2017

3. FEC Committee ID #: C00255752 This committee is a separate segregated fund. Its connected organization is a Trade Association
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

AMERICAN SOCIETY OF ANESTHESIOLOGISTS
1061 American Lane
Schaumburg, Illinois 60173
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Dennis Rizzo
1061 American Lane
Schaumburg, IL 60173
Title: Treasurer
Phone # (847) 825-5586

Treasurer:

Mr. Dennis Rizzo
1061 American Lane
Schaumburg, Illinois 60173
Title: Treasurer
Phone # (847) 825-5586

Designated Agent(s):

Ms. Lisa Norman
1061 American Lane
Schaumburg, Illinois 60173
Title: Assistant Treasurer
Phone # (847) 825-5586

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1183262

1. American Society of Anesthesiologists Political Action Committee

NOTE: Email address is different than previously reported

2. Date: 09/21/2017

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Mr. Dennis Rizzo
Date Signed: 09/21/2017

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1183262

1. American Society of Anesthesiologists Political Action Committee

NOTE: Email address is different than previously reported

2. Date: 09/21/2017

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Mr. Dennis Rizzo Date Signed: 09/21/2017

(End FEC FORM 1)

Signed: Mr. Dennis Rizzo
Date Signed: 09/21/2017