FEC Form 1 for HEARPAC OF HEARING INDUSTRIES ASSOCIATIONForm 1 for HEARPAC OF HEARING INDUSTRIES ASSOCIATION

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1102305

1. HEARPAC OF HEARING INDUSTRIES ASSOCIATION

1444 I St., NW, Suite 700
Washington, DC 20005
Email: kwolford@bostrom.com;abopp@bostrom.com

NOTE: Email address is different than previously reported

2. Date: 10/04/2016

3. FEC Committee ID #: C00437798 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

Hearing Industries Association
1444 I St. NW Suite 700
Washington, DC 20005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Brandon Sawalich
6425 Beach Rd.
Eden Prairie, MN 55344
Title: Treasurer
Phone # (202) 712-9050

Treasurer:

Brandon Sawalich
6425 Beach Rd.
Eden Prairie, Minnesota 55344
Title: Treasurer
Phone # (202) 712-9050

Designated Agent(s):

Carole M. Rogin
50 East Road, #10E
Delray Beach, Florida 33483
Title: President
Phone # (202) 712-9033

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1102305

1. HEARPAC OF HEARING INDUSTRIES ASSOCIATION

NOTE: Email address is different than previously reported

2. Date: 10/04/2016

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Brandon Sawalich
Date Signed: 10/04/2016

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1102305

1. HEARPAC OF HEARING INDUSTRIES ASSOCIATION

NOTE: Email address is different than previously reported

2. Date: 10/04/2016

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Brandon Sawalich Date Signed: 10/04/2016

(End FEC FORM 1)

Signed: Brandon Sawalich
Date Signed: 10/04/2016