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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1065110

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1. Senior Care Pharmacy Coalition PAC

    601 13th Street NW
    11th Floor
    Washington, DC 20005
    Email: smurdock@seniorcarepharmacies.org

2. Date: 04/19/2016

3. FEC Committee ID #: C00615203 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Senior Care Pharmacy Coalition
601 13th Street NW
11th Floor
Washington, DC 20005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Susan Murdock
601 13th Street, NW
11th Floor
Washington, DC 20005
Title: Custodian of Records
Phone # (202) 534-1783

Treasurer:

Alan Rosenbloom
601 13th Street, NW
11th Floor
Washington, DC 20005
Title: Treasurer
Phone # (202) 534-1783

Designated Agent(s):

Michael Bronfein
601 13th Street, NW
11th Floor
Washington, DC 20005
Title: Assistant Treasurer
Phone # (202) 534-1783

Banks or Depositories

PNC Bank
800 17th Street, NW
Washington, DC 20006

Signed: Alan Rosenbloom
Date Signed: 04/19/2016

(End FEC FORM 1)

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