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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-745036

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1. Kidney Care Council Political Action Committee

    NOTE:Commmittee Name is different than previously reported

    1200 G Street, NW
    Regus HQ Suite 841
    Washington, DC 20005

    NOTE: Address is different than previously reported

    Email: ccepriano@kidneycarecouncil.org

2. Date: 09/16/2011

3. FEC Committee ID #: C00326736 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

Kidney Care Council
1200 G Street NW
Regus HQ Suite 841
Washington, DC 20005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Cherilyn Cepriano
1200 G Street, NW
Regus HQ Suite 841
Washington, DC 20005
Title: Custodian of Records
Phone # (202) 744-2124

Treasurer:

Cherilyn Cepriano
1200 G Street, NW
Regus HQ Suite 841
Washington, DC 20005
Title: Treasurer
Phone # (202) 744-2124

Designated Agent(s):

Regina Sherick
The Atlantic Building
950 F Street, NW
Washington, DC 20004
Title: Assistant Treasurer
Phone # (202) 756-3300

Banks or Depositories

United Bank
1275 Pennsylvania Avenue NW
Washington, DC 20004

Signed: Cherilyn Cepriano
Date Signed: 09/16/2011

(End FEC FORM 1)

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