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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-486727

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1. NEXION HEALTH FUND FOR QUALITY LONG TERM CARE INC

    228 S WASHINGTON STREET SUITE 115
    ALEXANDRIA, VA 22314
    Email: kdavis@hdafec.com

2. Date: 08/11/2010

3. FEC Committee ID #: C00434233 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Nexion Health, Inc.
6937 Warfield Avenue
Sykesville, Maryland 21784
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Francis P. Kirley
6937 Warfield Avenue
Sykesville, MD 21784
Title: Treasurer
Phone # (703) 549-7705

Treasurer:

Francis P. Kirley
6937 Warfield Avenue
Sykesville, Maryland 21784
Title: Treasurer
Phone # (703) 549-7705

Designated Agent(s):

Keith A. Davis
Huckaby Davis Lisker
228 S. Washington Street., #115
Alexandria, Virginia 22314
Title: Assistant Treasurer
Phone # (703) 549-7705

Banks or Depositories

Wachovia Bank
7 Saint Paul Street
Baltimore, Maryland 21202

Signed: Francis P. Kirley
Date Signed: 08/11/2010

(End FEC FORM 1)

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