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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-30399

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1. Louisiana State Medical Society Political Action Committee (LAMPAC)

    NOTE:Commmittee Name is different than previously reported

    6767 Perkins Rd #100
    Baton Rouge, LA 70808
    Email: wcassi@lsuhsc.edu

2. Date: 07/06/2001

3. FEC Committee ID #: C00001008 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Louisiana State Medical Society
6767 Perkins Road #100
Baton Rouge, Louisiana 70808
Relationship: Connected Organizations
Organization Type: Trade Association

Custodian of Records:

Mary DuCote
6767 Perkins Road #100
Baton Rouge, LA 70808
Title: PAC Administrator
Phone # (225) 763-8500

Treasurer:

William Cassidy
6767 Perkins Rd #100
Baton Rouge, Louisiana 70808
Title: Treasurer
Phone # (225) 358-1096

Designated Agent(s):

William Cassidy
6767 Perkins Rd #100
Baton Rouge, Louisiana 70808
Title: Treasurer
Phone # (225) 358-1096

Banks or Depositories

Hancock Bank
P O Box 591
Baton Rouge, Louisiana 70821

Salomon Smith Barney Inc.
8550 United Plaza Blvd #101
Baton Rouge, Louisiana 70809


Hancock Bank
P O Box 591
Baton Rouge, Louisiana 70821


Salomon Smith Barney Inc.
8550 United Plaza Blvd #101
Baton Rouge, Louisiana 70809

Signed: William Cassidy, MD
Date Signed: 03/21/2002

(End FEC FORM 1)

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