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

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-404353

1. California Medical Association Political Action Committee - Federal

1201 J Street, Suite 375
Sacramento, CA 95814
Email: sandyb@eichmancpa.com

2. Date: 02/18/2009

3. FEC Committee ID #: C00003194 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

California Medical Association
1201 J Street, Suite 375
Sacramento, California 95814
Affiliated Relationship Code: Connected Organization

American Medical Association
1101 Vermont Avenue, SW
Washington, DC 20005
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Robert Margolin, MD
2001 Union Street, Suite 570
San Francisco, CA 94123
Title: Custodian of Records
Phone # (415) 694-7500

Treasurer:

Robert Margolin, MD
2001 Union Street, Suite 570
San Francisco, California 94123
Title: Treasurer
Phone # (415) 694-7500

Designated Agent(s):

Banks or Depositories

UBOC
700 L Street
Sacramento, California 95814

Signed: Robert Margolin, MD
Date Signed: 02/18/2009

FORM TEXT

(End FEC FORM 1)

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