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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1676002

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1. Association for Community Affiliated Plans Political Action Committee

    1155 15th Street NW, Suite 600
    Washington, DC 20005
    Email: sgibson@communityplans.net;jhunter@kelleydrye.com

2. Date: 01/13/2023

3. FEC Committee ID #: C00831313 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Association for Community Affiliated Plans
1155 15th Street NW, Suite 600
Washington, DC 20005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Pramila Shrestha
1155 15th Street NW, Suite 600
Washington, DC 20005
Title: Custodian of Records
Phone # (202) 204-7508

Treasurer:

Sharon Gibson
1155 15th Street NW, Suite 600
Washington, DC 20005
Title: Treasurer
Phone # (202) 204-7508

Designated Agent(s):

Heather Foster
1155 15th Street NW, Suite 600
Washington, DC 20005
Title: Asst Treasurer
Phone # (202) 204-7508

Banks or Depositories

Truist
1099 New York Ave, NW
Ste 100
Washington, DC 20001

Signed: Sharon Gibson
Date Signed: 01/13/2023

(End FEC FORM 1)

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