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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1334444

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1. America's Essential Hospitals Political Action Committee, (Essential Hospitals PAC)

    401 9th Street, NW
    Suite 900
    Washington, DC 20004
    Email: cjackson@essentialhospitals.org

2. Date: 06/18/2019

3. FEC Committee ID #: C00602805 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

America's Essential Hospitals
401 9th Street, NW
Suite 900
Washington, DC 20004
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Aimee Steel Lubin
800 17th Street, NW
Suite 1100
Washington, DC 20006
Title: Custodian of Records
Phone # (202) 828-1895

Treasurer:

Carlos Jackson
401 9th St NW
Suite 900
Washington, DC 20004
Title: Treasurer
Phone # (202) 585-0100

Designated Agent(s):

Margaret Peterson
401 Ninth Street, NW
Ste 900
Washington, DC 20004
Title: Assistant Treasurer
Phone # (202) 585-0551

Banks or Depositories

Bank of America
730 15th Street, NW
Washington, DC 20004

Signed: Carlos Jackson
Date Signed: 06/18/2019

(End FEC FORM 1)

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