FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-280890
1. FEDERATION OF AMERICAN HOSPITALS PAC
801 PENNSYLVANIA AVENUESUITE 245
WASHINGTON, DC 200042604
Email: jmicklos@fah.org
2. Date: 03/14/2007
3. FEC Committee ID #: C00002261 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Federation of American Hospitals801 Pennsylvania Ave. NW
Suite 245
Washington, DC 20004
Relationship: Connected
Organization Type: Trade Association
Custodian of Records:
Mr. Alex Mullineaux801 Pennsylvania Ave N.W.
Suite 245
Washington, DC 200042604
Title: PAC Director/Policy
Phone # (202) 624-1526
Treasurer:
Mr. Jeffrey Micklos801 Pennsylvania Avenue N.W.
Suite 245
Washington, DC 200042604
Title: Senior Vice Presiden
Phone # (202) 624-1521
Designated Agent(s):
Mr. Jeffrey Micklos801 Pennsylvania Ave. NW
Suite 245
Washington, DC 20004
Title: Treasurer
Phone # (202) 624-1521
Banks or Depositories
Wachovia National Bank801 Pennsylvania Ave. NW
Washington, DC 20004