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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-442993

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1. UNITED AMERICAN NURSES AFL-CIO REGISTERED NURSE POLITICAL ACTION COMMITTEE UAN RN PAC

    8630 Fenton Street
    Suite 1100
    Silver Spring, MD 20910
    Email: Charles.Lorenzetti@uannurse.org

    NOTE: Email address is different than previously reported

2. Date: 12/21/2009

3. FEC Committee ID #: C00446237 This committee is a separate segregated fund. Its connected organization is a Labor Organization

Affiliated Committees/Organizations

United American Nurses
8630 Fenton Street
Suite 1100
Silver Spring, Maryland 20910
Affiliated Relationship Code: Connected Organization

Committee ID# C00360438
CA NURSES ASSOC./NAT'L. NURSES ORGANIZ
555 Capitol Mall, Suite 1425
Sacramento, California 95814
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Carolyn Hietamaki
8630 Fenton Street
Suite 1100
Silver Spring, MD 20910
Title: Custodian of Records
Phone # (240) 821-1815

Treasurer:

Carolyn Hietamaki
8630 Fenton Street
Suite 1100
Silver Spring, Maryland 20910
Title: Treasurer
Phone # (240) 821-1815

Designated Agent(s):

Banks or Depositories

Sun Trust Bank
1445 New York Avenue, NW
Washington, DC 20005

Signed: Carolyn Hietamaki
Date Signed: 12/21/2009

(End FEC FORM 1)

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