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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-434230

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1. National Community Pharmacists Association - PAC

    100 Daingerfield Road
    Alexandria, VA 223142885
    Email: Amy.Mathis@ncpanet.org

    NOTE: Email address is different than previously reported

2. Date: 10/05/2009

3. FEC Committee ID #: C00030809 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Miss Amy H Mathis
763 10th St SE
Washington, DC 20003
Title: Director
Phone # (703) 600-1180

Treasurer:

Mr. B. Douglas Hoey
1104 Emerald Dr
Alexandria, Virginia 22308
Title: SR VP & COO
Phone # (703) 683-8200

Designated Agent(s):

Banks or Depositories

Virginia Commerce Bank
1414 Prince Street
Alexandria, Virginia 22314

Signed: Mr. B. Douglas Hoey
Date Signed: 10/05/2009

(End FEC FORM 1)

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