FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-1383864
1. AKSM Urology Political Action Committee 'AKSM Urology PAC'
100 W 3rd AveSte 350
Columbus, OH 432017205
Email: PHajjar@ums-usa.com;natalie@nkbaurassociates.com
2. Date: 02/19/2020
3. FEC Committee ID #: C00489419This 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:
Tara Perdue
100 West Third
Suite 350
Columbus, OH 432017205
Title: Custodian of Records
Phone # (614) 298-8150
Treasurer:
Mr. Paul Hajjar
1700 West Park Drive
Suite 410
Westborough, Massachusetts 015813915
Title: Treasurer
Phone # (580) 870-6565
Designated Agent(s):
Tara Perdue
100 West Third
Suite 350
Columbus, Ohio 432017205
Title: Assistant Treasurer
Phone # (614) 298-8150
Banks or Depositories
JP Morgan Chase
100 E. Broad Street
10th Floor, OH1-0170
Columbus, Ohio 43215
Signed: Mr. Paul Hajjar
Date Signed: 02/20/2020
(End FEC FORM 1)
Date Signed: 02/20/2020