FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-753955
1. North Carolina Dental Society PAC
1600 Evans RoadCary, NC 27513
Email: LWard@ncdental.org
2. Date: 12/02/2011
3. FEC Committee ID #: C00012211 This committee is a separate segregated fund. Its connected organization is a Membership OrganizationAffiliated Committees/Organizations
North Carolina Dental Society1600 Evans Road
Cary, North Carolina 27513
Affiliated Relationship Code: Connected Organization
Committee ID# C00000729
AMERICAN DENTAL ASSOCIATION POLITICAL
1111 14TH STREET, NW
SUITE 1100
WASHINGTON, DC 20005
Affiliated Relationship Code: Affiliated Committee
Custodian of Records:
Lisa Ward1600 Evans Road
Cary, NC 27513
Title: Custodian of Records
Phone # (919) 677-1396
Treasurer:
Dr. Evelyn M. Brown455 Swiftside Dr
Suite 101
Cary, North Carolina 27518
Title: Treasurer
Phone # (919) 677-1396
Designated Agent(s):
Dr. M. Alec Parker, DMD1600 Evans Road
Cary, North Carolina 27513
Title: Assistant Treasurer
Phone # (919) 677-1396
Banks or Depositories
RBC Bank7033 Lewis Stephens Dr
Morrisville, North Carolina 27560