FEC Form 1 for NEW MEXICO MEDICAL SOCIETY POLITICAL ACTION COMMITTEE (AKA NEMPAC)Form 1 for NEW MEXICO MEDICAL SOCIETY POLITICAL ACTION COMMITTEE (AKA NEMPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-261788

1. NEW MEXICO MEDICAL SOCIETY POLITICAL ACTION COMMITTEE (AKA NEMPAC)

7770 JEFFERSON NE #400
ALBUQUERQUE, NM 87109
Fax: 5058234760
Email: gama@gamamed.org

2. Date: 12/05/2006

3. FEC Committee ID #: C00001776 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

New Mexico Medical Society
7770 Jefferson NE
Suite 400
Albuquerque, New Mexico 87109
Relationship: connected
Organization Type: Corporation

Custodian of Records:

Mr. Thomas A. Bodnar
7770 Jefferson NE
Suite 400
Albuquerque, NM 87109
Title: Ass't. Tressurer
Phone # (505) 821-4583

Treasurer:

Dr. Stephen Haynes
7770 Jefferson N3`
Suite 400
Albuquerque, New Mexico 87109
Title: Treasurer
Phone # (505) 828-0237

Designated Agent(s):

Mr. Thomas A. Bodnar
7770 Jefferson NE
Suite 400
Albuquerque, New Mexico 87109
Title: Ass't. Treasurer
Phone # (505) 821-4583

Banks or Depositories

Bank of the West
5301 Central Ave. NE
Albuquerque, New Mexico 87108

Signed: Mr. Thomas A. Bodnar
Date Signed: 12/05/2006
Official Committee FAX: 5058234760

(End FEC FORM 1)

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