FEC Form 1 for American Hospital Association PACForm 1 for American Hospital Association PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-409833

1. American Hospital Association PAC

325 Seventh Street, NW
Suite 700
Washington, DC 20004
Email: kvaughan@aha.org

2. Date: 03/26/2009

3. FEC Committee ID #: C00106146 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

American Hospital Association
325 Seventh Street, NW
Suite 700
Washington, DC 20004
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Ms. Katie Vaughan
325 Seventh Street, NW
Suite 700
Washington, DC 20004
Title: Associate Director,

Treasurer:

Ms. Melinda Hatton
325 Seventh Street, NW
Suite 700
Washington, DC 20004
Title: Treasurer
Phone # (202) 626-2336

Designated Agent(s):

Banks or Depositories

Citibank
1400 G Street, NW
Washington, DC 20005

Signed: Ms. Melinda Hatton
Date Signed: 03/26/2009

FORM TEXT

(End FEC FORM 1)

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