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-266170

1. AMERICAN MEDICAL ASSOCIATION POLITICAL ACTION COMMITTEE

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

2. Date: 12/20/2006

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

SHELDON G GROSS, MD
3139 IRON STONE LAND
SAN ANTONIO, Texas 78230
Title: Secretary
Phone # (210) 614-3737

Banks or Depositories

PNC ADVISORS
PO BOX 96211
WASHINGTON, DC 20090

PNC BANK
PO BOX 1912
WASHINGTON, DC 20074

Signed: KEVIN WALKER
Date Signed: 12/20/2006
Official Committee URL: AMPACONLINE.ORG
Official Committee FAX: 2027897469

FORM TEXT

(End FEC FORM 1)

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