FEC Form 1 for American Optometric Association Political Action CommitteeForm 1 for American Optometric Association Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-177700

1. American Optometric Association Political Action Committee

1505 Prince Street
Suite 300
Alexandria, VA 22314
Fax: 0-
Email: NBrazil@theaoa.org

2. Date: 06/30/2005

3. FEC Committee ID #: C00024968 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

American Optometric Association
1505 Prince Street
Suite 300
Alexandria, Virginia 22314
Relationship: Parent Organization
Organization Type: Membership Organization

Custodian of Records:

Phone # 0

Treasurer:

Vincent Brandys, O.D.
1505 Prince Street
Suite 300
Alexandria, Virginia 22314
Title: NBrazil@aoa.org
Phone # 0

Designated Agent(s):

Banks or Depositories

WACHOVIA
1650 Tyson Blvd.
McLean, Virginia 22102

Signed: Vincent Brandys, O.D.
Date Signed: 06/30/2005
Official Committee FAX: 0-

FORM TEXT

(End FEC FORM 1)

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