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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-950636

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1. American Gastroenterological Association Inc. PAC

    4926 Del Ray Avenue
    Bethesda, MD 20814

    NOTE: Address is different than previously reported

    Email: nbuttar@gastro.org

2. Date: 06/02/2014

3. FEC Committee ID #: C00423228 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 Gastroenterological Association, Inc.
4926 Del Ray Avenue
Bethesda, Maryland 20814
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Lauren DePutter
4720 Montgomery Lane
Suite 430
Bethesda, MD 20814
Title: Manager
Phone # (240) 482-3221

Treasurer:

Francis M. Giardiello, MD
4720 Montgomery Lane
Suite 430
Bethesda, Maryland 20814
Title: Treasurer
Phone # (240) 482-3220

Designated Agent(s):

Thomas J. Serena, MBA, CPA
4720 Montgomery Lane
Suite 430
Bethesda, Maryland 20814
Title: Assistant Treasurer
Phone # (301) 654-2055

Banks or Depositories

WACHOVIA BANK
7901 Wisconsin Avenue
Bethesda, Maryland 20814

Signed: Francis M. Giardiello, MD
Date Signed: 09/12/2014

(End FEC FORM 1)

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