FEC Form 1 for Spine PAC of the National Association of Spine SpecialistsForm 1 for Spine PAC of the National Association of Spine Specialists

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1137997

1. Spine PAC of the National Association of Spine Specialists

7075 Veterans Blvd.
Burr Ridge, IL 60527
Email: jabushawish@spine.org;mkroll@spine.org

NOTE: Email address is different than previously reported

2. Date: 01/02/2017

3. FEC Committee ID #: C00349225 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

National Association of Spine Specialists
7075 Veterans Blvd
Burr Ridge, Illinois 605275614
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Mr. Eric J. Muehlbauer
7075 Veterans Blvd
Burr Ridge, Illinois 605275614
Title: Treasurer
Phone # (630) 230-3600

Designated Agent(s):

Banks or Depositories

BMO Harris Bank
111 West Monroe Street, 5C
Chicago, Illinois 60603

Signed: Mr. Eric J. Muehlbauer
Date Signed: 01/10/2017

(End FEC FORM 1)

Generated Thu Jul 11 17:12:31 2024