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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-226366

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1. OREGON MEDICAL POLITICAL ACTION COMMITTEE

    5210 SW CORBETT AVENUE
    PORTLAND, OR 972393897
    Fax: 5032417148
    Email: sarita@theoma.org

2. Date: 06/01/2006

3. FEC Committee ID #: C00035766 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Sarita Marfin
OMA
5210 SW Corbett Ave
Portland, OR 97239
Title: Admin Assistant
Phone # (503) 266-1555

Treasurer:

SCOTT GALLANT
5210 SW CORBETT AVE
PORTLAND, Oregon 97239
Title: Treasurer OMPAC
Phone # (503) 226-1555

Designated Agent(s):

Banks or Depositories

Signed: SCOTT GALLANT
Date Signed: 06/13/2006
Official Committee FAX: 5032417148

(End FEC FORM 1)

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