FEC Form 1 for AMERICAN MEDICAL ASSOCIATION POLITICAL ACTION COMMITTEEForm 1 for AMERICAN MEDICAL ASSOCIATION POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-167194

1. AMERICAN MEDICAL ASSOCIATION POLITICAL ACTION COMMITTEE

1101 VERMONT AVENUE NW
12TH FLOOR
WASHINGTON, DC 20005
Fax: 2027897469
Email: EVA_PETTY@AMA-ASSN.ORG

2. Date: 09/24/2003

3. FEC Committee ID #: C00000422 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

KEVIN WALKER
10635 CANTERBERRY ROAD
FAIRFAX STATION, Virginia 22039
Title: TREASURER
Phone # (202) 789-7467

Designated Agent(s):

MICHAEL CYS
7415 SOUTH REACH DRIVE
FAIRFAX STATION, Virginia 22039
Title: ASSISTANT TREASURER
Phone # (202) 789-7457

JOHN F LEARY
403 RUSSELL ROAD
ALEXANDRIA, Virginia 22301
Title: ASSISTANT TREASURER
Phone # (202) 789-7433

ROBERT BONVINO, MD
206 DOE TRAIL
MORGANVILLE, New Jersey 07751
Title: Secretary
Phone # (732) 772-0062

Banks or Depositories

Signed: KEVIN WALKER
Date Signed: 03/11/2005
Official Committee URL: AMPACONLINE.ORG
Official Committee FAX: 2027897469

FORM TEXT

(End FEC FORM 1)

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