FEC Form 1 for California Medical Political Action Committee - FederalForm 1 for California Medical Political Action Committee - Federal

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-259578

1. California Medical Political Action Committee - Federal

1201 J Street Suite 375
Sacramento, CA 95814

2. Date: 11/21/2006

3. FEC Committee ID #: C00003194 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

California Medical Association
1201 J Street Suite 375
Sacramento, California 95814
Relationship: Sponsor

Amercan Medical Association
1101 Vermont Avenue SW
Washington, DC 20005
Relationship: Affiliated Organization

Custodian of Records:

Richard Thorpe
5730 Canyon View Drive
Paradise, CA 95969
Title: Custodian of Records

Treasurer:

Richard Thorpe
5730 Canyon View Drive
Paradise, California 95969
Title: Treasurer
Phone # (916) 551-2571

Designated Agent(s):

Dean Chalios
1201 J Street Suite 375
Sacramento, California 95814
Title: Assistant Treasurer
Phone # (916) 444-5532

Banks or Depositories

Bank of America
One Market Plaza
San Francisco, California 94105

Signed: Richard Thorpe
Date Signed: 11/21/2006

(End FEC FORM 1)

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