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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-973391

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1. National Emergency Medicine Political Action Committee

    1125 Executive Circle
    Irving, TX 75038
    Email: scheng@acep.org

    NOTE: Email address is different than previously reported

2. Date: 11/21/2014

3. FEC Committee ID #: C00140061 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

American College of Emergency Physicians
1125 Executive Circle
Irving, Texas 75038
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Sam Cheng
1125 Executive Circle
Irving, TX 75038
Title: PAC Treasurer
Phone # (972) 550-0911

Treasurer:

Mr. Sam Cheng
1125 Executive Circle
Irving, Texas 75038
Title: PAC Treasurer
Phone # (972) 550-0911

Designated Agent(s):

Banks or Depositories

JPMorgan Chase Bank NA
1717 Main Street
3rd Floor
Dallas, Texas 75201

MorganStanley SmithBarney
1050 Connecticut NW

Washington, DC 20036

Signed: Mr. Sam Cheng
Date Signed: 11/21/2014

(End FEC FORM 1)

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