FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-415938
1. Utah Medical Political Action Committee
310 East 4500 SouthSuite 500
Salt Lake City,, UT 841074250
NOTE: Address is different than previously reported
Email: claudia@utahmed.orgNOTE: Email address is different than previously reported
2. Date: 03/27/2009
3. FEC Committee ID #: C00003210This committee is an independent expenditure-only political committee (Super PAC).
Affiliated Committees/Organizations
Committee ID# C00000422
American Medical Political Action Committee
1101 Vermont Ave., NW
Chicago,, Illinois 20005
Affiliated Relationship Code: Affiliated Committee
Custodian of Records:
Ms Claudia S Peterson
310 East 4500 So
SLC, UT 84107
Title: Acctng Mng
Phone # (801) 747-3500
Treasurer:
Michelle McOmber
310 East 4500 So.
SLC, Utah 84107
Title: Asst Exec VP
Phone # (801) 747-3500
Designated Agent(s):
Michelle McOmber
310 East 4500 So.
SLC, Utah 84107
Val J Bateman
310 East 4500 South
Suite 500
Salt Lake City,, Utah 841074250
Title: Exec VP
Phone # (801) 747-3500
Banks or Depositories
Wells Fargo
299 South Main, 11th Floor
SLC, Utah 84111
Signed: Michelle McOmber
Date Signed: 05/04/2009
(End FEC FORM 1)
Date Signed: 05/04/2009