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-410221

1. Spine PAC of the National Association of Spine Specialists

7075 Veterans Blvd.
Burr Ridge, IL 60527
Email: nschilligo@spine.org

2. Date: 03/28/2009

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 60527
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Nicholas A. Schilligo
7075 Veterans Blvd.
Burr Ridge, IL 60537
Title: Snr. Manager of Advo
Phone # (630) 230-3671

Treasurer:

Mr. Eric J. Muehlbauer
7075 Veterans Blvd.
Burr Ridge, Illinois 60527
Title: Executive Director
Phone # (630) 230-3600

Designated Agent(s):

Banks or Depositories

JP Morgan Chase Bank
PO Box 260180
Baton Rouge, Louisiana 70828

Signed: Mr. Eric J. Muehlbauer
Date Signed: 03/28/2009
Official Committee URL: www.spineadvocate.org

NOTE: URL is different than previously reported

(End FEC FORM 1)

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