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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1743868

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1. AMERICAN ASSOCIATION OF ORAL AND MAXILLOFACIAL SURGEONS POLITICAL ACTION COMMITTEE

    9700 WEST BRYN MAWR AVE.
    ROSEMONT, IL 60018
    Email: tmacino@aaoms.org

2. Date: 01/17/2024

3. FEC Committee ID #: C00005660 This committee is a separate segregated fund. Its connected organization is a Membership Organization
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

American Association of Oral and Maxillofacial Surgeons
9700 W. Bryn Mawr
Rosemont, Illinois 60018
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Steven M Roser
1365 Clifton Rd NE Ste 2300B
Atlanta, GA 30322
Title: Treasurer
Phone # (847) 678-6200

Treasurer:

Steven M Roser
1365 Clifton Rd NE Ste 2300B
Atlanta, Georgia 30322
Title: Treasurer
Phone # (847) 678-6200

Designated Agent(s):

Jeanne Tuerk
9700 W Bryn Mawr Ave
Rosemont, Illinois 60018
Title: Assistant Treasurer
Phone # (847) 678-6200

Steven M Roser
1365 Clifton Rd NE Ste 2300B
Atlanta, Georgia 30322
Title: Treasurer
Phone # (847) 678-6200

Banks or Depositories

Fifth Third Bank
6111 North River Rd
Rosemont, Illinois 60018

Signed: Steven M Roser
Date Signed: 01/17/2024

(End FEC FORM 1)

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