FEC Form 1 for The American Occupational Therapy Association Inc. Political Action Committee (AOTPAC)Form 1 for The American Occupational Therapy Association Inc. Political Action Committee (AOTPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-175269

1. The American Occupational Therapy Association Inc. Political Action Committee (AOTPAC)

NOTE:Commmittee Name is different than previously reported

4720 Montgomery Lane
PO Box 31220
Bethesda, MD 208241220
Fax: 301-652-7711
Email: aotpac@aota.org

2. Date: 05/24/2005

3. FEC Committee ID #: C00089086 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

The American Occupational Therapy Association Inc.
4720 Montgomery Lane
PO Box 31220
Bethesda, Maryland 208241220
Relationship: parent organization
Organization Type: Membership Organization

Custodian of Records:

Darlene C Dennis
4720 Montgomery Lane
PO Box 31220
Bethesda, MD 208241220
Title: Political Action Adm
Phone # (301) 652-2682

Treasurer:

Christina A. Metzler
4720 Montgomery Lane
PO Box 31220
Bethesda, Maryland 20824
Title: Chief Public Policy
Phone # (301) 652-2682

Designated Agent(s):

Chuck Partridge
4720 Montgomery Lane
PO Box 31220
Bethesda, Maryland 208241220
Title: Assistant Treasurer
Phone # (301) 652-2682

Banks or Depositories

SunTrust Bank
1445 New York Ave NW
Washington, DC 20005

Signed: Christina A. Metzler
Date Signed: 05/24/2005
Official Committee FAX: 301-652-7711

FORM TEXT

(End FEC FORM 1)

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