FEC Form 1 for American College of Cardiology Political Action CommitteeForm 1 for American College of Cardiology Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-196686

1. American College of Cardiology Political Action Committee

9111 Old Georgetown Road
Bethesda, MD 208141699
Email: rgoldber@acc.org

2. Date: 01/19/2006

3. FEC Committee ID #: C00375360 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

American College of Cardiology
9111 Old Georgetown Road
Bethesda, Maryland 208141699
Relationship: Connected Organization
Organization Type: Membership Organization

Custodian of Records:

Frank Ryan
9111 Old Georgetown Road
Bethesda, MD 208141699
Title: Assistant Treasurer
Phone # (301) 581-3409

Treasurer:

Richard Goldberg
9111 Old Georgetown Road
Bethesda, Maryland 208141699
Title: PAC Treasurer
Phone # (301) 897-2638

Designated Agent(s):

Frank Ryan
9111 Old Georgetown Road
Bethesda, Maryland 208141699
Title: Assistant Treasurer
Phone # (301) 581-3409

Banks or Depositories

Sun Trust Bank
1445 New York Avenue N.W.
Washington, DC 20005

Signed: Richard Goldberg
Date Signed: 01/19/2006

(End FEC FORM 1)

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