FEC Form 1 for American Academy of Otolaryngology-Head and Neck Surgery ENT PACForm 1 for American Academy of Otolaryngology-Head and Neck Surgery ENT PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-304202

1. American Academy of Otolaryngology-Head and Neck Surgery ENT PAC

One Prince Street
Alexandria, VA 22314
Fax: 2025448454
Email: ENTPAC@entnet.org

2. Date: 09/20/2007

3. FEC Committee ID #: C00306449 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Committee ID# C00306449
American Academy of Otolaryngology-Head and Neck Surgery
One Prince Street
Alexandria, Virginia 22314
Relationship: Connected
Organization Type: Membership Organization

Custodian of Records:

Treasurer

Treasurer:

Tom Harlow
One Prince Street
Alexandria, Virginia 22314
Title: Chief Financial Offi
Phone # (703) 836-4444

Designated Agent(s):

Banks or Depositories

National Capital Bank of Washington
316 Pennsylvania Ave SE
Washington, DC 20003

Signed: Tom Harlow
Date Signed: 09/20/2007
Official Committee FAX: 2025448454

(End FEC FORM 1)

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