FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-283360
1. Kentucky Medical Association PAC (Kentucky Physicians PAC Federal - KPPAC Federal)
NOTE:Commmittee Name is different than previously reported
4965 US Highway 42 Suite 2000Louisville, KY 40222
Fax: 502-326-2696
Email: kppac@kyma.org
2. Date: 03/01/2002
3. FEC Committee ID #: C00016444 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Custodian of Records:
Katie RaffertySuite 2000
4965 US Highway 42
Louisville, KY 40222
Title: Custodian
Phone # (502) 426-6200
Treasurer:
Susan G. Bornstein MDSuite 2000
4965 US Highway 42
Louisville, Kentucky 40222
Title: Treasurer
Phone # (502) 426-6200
Designated Agent(s):
Banks or Depositories
PNC BankLouisville, Kentucky 40222