FEC Form 1 for American College of Physician Services Inc PAC; AKA ACP Services PACForm 1 for American College of Physician Services Inc PAC; AKA ACP Services PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-266565

1. American College of Physician Services Inc PAC; AKA ACP Services PAC

2011 Pennsylvania Avenue NW
Suite 800
Washington, DC 20006
Fax: 2028350443
Email: acpservicespac@acponline.org

2. Date: 12/27/2006

3. FEC Committee ID #: C00403881 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

American College of Physician Services Inc.
2011 Pennsylvania Avenue N.W.
Suite 800
Washington, DC 20006
Relationship: Connected
Organization Type: Membership Organization

Custodian of Records:

Mark A. Friend
2011 Pennsylvania Avenue N.W.
Washington, DC 20006
Title: Treasurer
Phone # (202) 261-4527

Treasurer:

Mark A. Friend
2011 Pennsylvania Avenue N.W.
Washington, DC 20006
Title: Treasurer
Phone # (202) 621-4527

Designated Agent(s):

Patrick Hope
2011 Pennsylvania Avenue N.W.
Suite 800
Washington, DC 20006
Title: Asst. Treasurer
Phone # (202) 261-4541

Banks or Depositories

Bank of America
2001 Pennsylvania Avenue NW
Washington, DC 20006

Signed: Mark A. Friend
Date Signed: 12/27/2006
Official Committee FAX: 2028350443

(End FEC FORM 1)

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