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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1319941

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1. AKSM Urology Political Action Committee 'AKSM Urology PAC'

    100 West Third Ave Suite 350
    Columbus, OH 43201
    Email: RHUGHES@AKSM.COM;nkbaur@aol.com

    NOTE: Email address is different than previously reported

2. Date: 12/14/2011

3. FEC Committee ID #: C00489419

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Ric Hughes
100 West Third Avenue, Suite 350
Columbus, OH 43201
Title: Treasurer
Phone # (614) 638-5180

Treasurer:

Ric Hughes
100 West Third Avenue, Suite 350
Columbus, Ohio 43201
Title: Treasurer
Phone # (614) 638-5180

Designated Agent(s):

Alan Buergenthal
100 West Third Avenue, Suite 350
Columbus, Ohio 43201
Title: Assistant Treasurer
Phone # (614) 638-5180

Banks or Depositories

JP Morgan Chase Bank, Commercial Banki
100 E. Broad Street
10th Floor, OH1-0170
Columbus, Ohio 43215

Signed: Ric Hughes
Date Signed: 03/19/2019

(End FEC FORM 1)

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