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FEC Form 1 for Consumer Healthcare Products Association PAC (CHPA/PAC)Form 1 for Consumer Healthcare Products Association PAC (CHPA/PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-497811


1. Consumer Healthcare Products Association PAC (CHPA/PAC)

    900 19th Street, NW
    Suite 700
    Washington, DC 20006
    Email: chpapac@chpa-info.org

2. Date: 10/12/2010

3. FEC Committee ID #: C00040584 This committee is a separate segregated fund. Its connected organization is a Trade Association
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Committee ID# C00040584
Consumer Healthcare Products Association PAC (CHPA/PAC)
900 19th Street, NW
Suite 700
Washington, DC 20006
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Travis M. Gibbons
900 19th Street NW
Suite 700
Washington, DC 20006
Phone # (202) 429-9260

Treasurer:

Roman G. Blazauskas
900 19th Street NW
Suite 700
Washington, DC 20006
Title: Treasurer
Phone # (202) 429-9260

Designated Agent(s):

Banks or Depositories

Wachovia Bank
1800 K Street, NW
Washington, DC 20006

Signed: Roman G. Blazauskas
Date Signed: 10/12/2010

(End FEC FORM 1)


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