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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-104688

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1. AAHP/HIAA PAC

    NOTE:Commmittee Name is different than previously reported

    601 Penn. Avenue NW
    #500 South Bldg.
    WASHINGTON, DC 20004

    NOTE: Address is different than previously reported

    Fax: 2029554397
    Email: cjervis@aahp.org

2. Date: 10/31/2003

3. FEC Committee ID #: C00106740 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

AAHP/HIAA Association
601 Penn. Ave. NW
#500 South Bldg.
Washington, DC 20004
Relationship: Connected Organizati
Organization Type: Trade Association

Custodian of Records:

Cheryl Jervis
601 Penn. Ave NW
#500 South Bldg.
Washington, DC 20004
Title: Exec.Dir. of Finance
Phone # (202) 778-3217

Treasurer:

Robert Borchardt
17434 Avenleigh Dr.
Ashton, Maryland 20861
Title: Treasurer
Phone # (202) 778-3214

Designated Agent(s):

Banks or Depositories

Riggs National Bank
1913 Mass. Ave. NW
Washington, DC 20036

Signed: Robert Borchardt
Date Signed: 10/31/2003
Official Committee FAX: 2029554397

(End FEC FORM 1)

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