FEC Form 1 for College of American Pathologists Political Action CommitteeForm 1 for College of American Pathologists Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-407386

1. College of American Pathologists Political Action Committee

1350 I Street, NW
Suite 590
Washington, DC 20005
Email: dfroemm@cap.org

2. Date: 03/13/2009

3. FEC Committee ID #: C00274944 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

College of American Pathologists
325 Waukegan Road
Northfield, Illinois 60093
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Susan Askew
1350 I Street, NW
Suite 590
Washington, DC 20005
Title: Manager
Phone # (202) 354-8105

Treasurer:

Dr. Renee R Ellerbroek
1212 Pleasant Street
Suite LL3
Des Moines, Iowa 50309
Title: Treasurer
Phone # (515) 241-8870

Designated Agent(s):

Susan Askew
1350 I St NW
Suite 590
Washington, DC 200053341

Banks or Depositories

SunTrust Bank
1455 New York Avenue
Washington, DC 20005

Signed: Dr. Renee R Ellerbroek
Date Signed: 03/13/2009

(End FEC FORM 1)

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