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FEC Form 1 for SOCIETY FOR VASCULAR SURGERY POLITICAL ACTION COMMITTEEForm 1 for SOCIETY FOR VASCULAR SURGERY POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-92076

1. SOCIETY FOR VASCULAR SURGERY POLITICAL ACTION COMMITTEE

    NOTE:Commmittee Name is different than previously reported

    900 Cummings Center 221U
    BEVERLY, MA 01915

    NOTE: Address is different than previously reported

    Fax: 9785248890

2. Date: 07/17/2003

3. FEC Committee ID #: C00381459 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Society for Vascular Surgery
900 Cummings Center
221U
Beverly, Massachusetts 01915
Relationship: Connected
Organization Type: Trade Association

Custodian of Records:

David Cloud
900 Cummings Center
221U
Beverly, MA 01915
Title: Executive Director
Phone # (978) 526-8330

Treasurer:

Dr. Robert Zwolak
359 Dogford Road
Etna, New Hampshire 03750
Title: Treasurer
Phone # (603) 650-4682

Designated Agent(s):

David Cloud
900 Cummings Center
221U
Beverly, Massachusetts 01915
Title: Executive Director
Phone # (978) 526-8330

Banks or Depositories

Fleet Bank
100 Federal Street
Boston, Massachusetts 02110

Signed: Dr. Robert Zwolak
Date Signed: 07/28/2003
Official Committee FAX: 9785248890

(End FEC FORM 1)


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