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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-364171

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1. FEDERATION OF AMERICAN HOSPITALS PAC

    801 PENNSYLVANIA AVENUE
    SUITE 245
    WASHINGTON, DC 200042604
    Email: csmith@fah.org

2. Date: 09/17/2008

3. FEC Committee ID #: C00002261 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Federation of American Hospitals
801 Pennsylvania Ave. NW
Suite 245
Washington, DC 20004
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Alex Mullineaux
801 Pennsylvania Ave, N.W.
Suite 245
Washington, DC 200042604
Title: PAC Director/Policy
Phone # (202) 624-1526

Treasurer:

Mrs. Karen Smith
801 Pennsylvania Avenue, N.W.
Suite 245
Washington, DC 200042604
Title: Vice President
Phone # (202) 624-1528

Designated Agent(s):

Mr. Jeffrey Micklos
801 Pennsylvania Ave. NW
Suite 245
Washington, DC 20004
Title: General Counsel
Phone # (202) 624-1521

Banks or Depositories

Wachovia National Bank
801 Pennsylvania Ave. NW
Washington, DC 20004

Signed: Mrs. Karen Smith
Date Signed: 09/16/2008
Official Committee URL: http://www.fah.org

(End FEC FORM 1)

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