FEC Form 1 for American Academy of Dermatology Association Political Action Committee (SkinPAC)Form 1 for American Academy of Dermatology Association Political Action Committee (SkinPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-442192

1. American Academy of Dermatology Association Political Action Committee (SkinPAC)

1445 New York Avenue NW
Ste 800
Washington, DC 20005
Email: SHewitt@aad.org

2. Date: 12/16/2009

3. FEC Committee ID #: C00359539 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

American Academy of Dermatology Association
1445 New York Avenue, NW
Ste 800
Washington, DC 20005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Samuel Hewitt
1445 New York Avenue NW
Ste 800
Washington, DC 20005
Title: Manager, Political A
Phone # (202) 712-2609

Treasurer:

Steven J. Debnar
1624 Kenyon Drive
Naperville, Illinois 60565
Title: Treasurer
Phone # (847) 240-1128

Designated Agent(s):

Banks or Depositories

JPMorgan Chase
111 E Busse Ave
Mount Prospect, Illinois 60056

Signed: Steven J. Debnar
Date Signed: 12/16/2009
Official Committee URL: www.skinpac.org

(End FEC FORM 1)

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