FEC Form 1 for Alaska State Medical Association Political Action Committee (ALPAC)Form 1 for Alaska State Medical Association Political Action Committee (ALPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1356049

1. Alaska State Medical Association Political Action Committee (ALPAC)

4107 Laurel Street
Anchorage, AK 99508
Email: cjeanes@asmadocs.org;asma@asmadocs.org

2. Date: 10/11/2019

3. FEC Committee ID #: C00001461 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

Alaska State Medical Association
4107 Laurel St
Anchorage, Alaska 99508

Custodian of Records:

Mr. Mike Haugen
4107 Laurel
Anchorage, AK 99508
Title: Treasurer
Phone # (907) 562-0304

Treasurer:

Mr. Mike Haugen
4107 Laurel
Anchorage, Alaska 99508
Title: Treasurer
Phone # (907) 562-0304

Designated Agent(s):

Cassie Jeanes
4107 Laurel St
Anchorage, Alaska 99508
Title: Office Manager
Phone # (907) 562-0304

Banks or Depositories

Wells Fargo Bank
P. O. Box 196124 MAC K33212-011
Anchorage, Alaska 995196127

Signed: Mr. Mike Haugen
Date Signed: 10/11/2019
Official Committee URL: asmadocs.org

(End FEC FORM 1)

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