FEC Form 1 for American Physical Therapy Association Physical Therapy Political Action Committee (PT-PAC)Form 1 for American Physical Therapy Association Physical Therapy Political Action Committee (PT-PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1499296

1. American Physical Therapy Association Physical Therapy Political Action Committee (PT-PAC)

3030 Potomac Avenue, Suite 100
Alexandria, VA 22305

NOTE: Address is different than previously reported

Email: MichaelMatlack@APTA.org

2. Date: 02/09/2021

3. FEC Committee ID #: C00012880 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 Physical Therapy Association
3030 Potomac Avenue, Suite 100
Alexandria, Virginia 22305
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Michael Matlack
3030 Potomac Avenue, Suite 100
Alexandria, VA 22305
Title: Associate Director o
Phone # (703) 706-3163

Treasurer:

Mr Justin Moore
3030 Potomac Avenue, Suite 100
Alexandria, Virginia 22305
Title: Vice President of Go
Phone # (703) 706-3162

Designated Agent(s):

Banks or Depositories

Wells Fargo Bank, N.A.
P.O. Box 63020
San Francisco, California 94163

Signed: Mr Justin Moore
Date Signed: 02/09/2021
Official Committee URL: ptpac.apta.org

NOTE: URL is different than previously reported

FORM TEXT-1

(End FEC FORM 1)

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