FEC Form 1 for America's Health Insurance Plans PAC (AHIP PAC)Form 1 for America's Health Insurance Plans PAC (AHIP PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-231199

1. America's Health Insurance Plans PAC (AHIP PAC)

NOTE:Commmittee Name is different than previously reported

601 Penn. Avenue NW
#500 South Bldg.
WASHINGTON, DC 20004
Fax: 2029554397
Email: fburkhart@ahip.org

2. Date: 07/28/2006

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

Affiliated Committees/Organizations

America's Health Insurance Plans AHIP
601 Penn. Ave. NW
#500 South Bldg.
Washington, DC 20004
Relationship: Connected Organization
Organization Type: Trade Association

Custodian of Records:

Frances Burkhart
601 Pennsylvania Ave NW
Suite #500 South Building
Washington, DC 20004
Title: Dir. of Pol. Affairs
Phone # (202) 778-3200

Treasurer:

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

Designated Agent(s):

Banks or Depositories

Citibank
1101 Pennsylvania Ave NW
11th Floor
Washington, DC 20004

Bank of America
730 15th Street NW
Second Floor
Washington, DC 20005

Signed: Robert Borchardt
Date Signed: 07/28/2006
Official Committee FAX: 2029554397

(End FEC FORM 1)

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