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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1238269

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1. Medical Professional Liability Association Political Action Committee (MPL PAC)

    NOTE:Commmittee Name is different than previously reported

    2275 Research Blvd
    Suite 250
    Rockville, MD 20850
    Email: mstinson@mplassociation.org

    NOTE: Email address is different than previously reported

2. Date: 06/15/2018

3. FEC Committee ID #: C00319319 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

Medical Professional Liability Association
2275 Research Boulevard
Ste. 250
Rockville, Maryland 20850
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Cindy Clemenza
9519 Briar Glen Way
Montgomery Village, MD 20886
Title: Executive Assistant
Phone # (240) 813-6128

Treasurer:

Brian Atchinson
13209 Moran Drive
North Potomac, Maryland 20878
Title: President/CEO
Phone # (240) 813-6143

Designated Agent(s):

Michael Stinson
3006 Bryan St.
Alexandria, Virginia 22302
Title: Assistant Treasurer
Phone # (240) 813-6139

Banks or Depositories

Merrill Lynch
1040 Stoney Hill Road, Ste. 1050
Yardley, Pennsylvania 19067

Signed: Brian Atchinson
Date Signed: 06/15/2018

(End FEC FORM 1)

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