FEC Form 1 for Cooperative of American Physicians Federal Political Action CommitteeForm 1 for Cooperative of American Physicians Federal Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-857993

1. Cooperative of American Physicians Federal Political Action Committee

333 S. Hope Street, 8th Floor
Los Angeles, CA 90071
Email: info@millerpoliticallaw.com

2. Date: 02/15/2013

3. FEC Committee ID #: C00161604 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Cooperative of American Physicians
333 South Hope
8th Floor
Los Angeles, California 90071
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Rebecca Olson
400 Capitol Mall Ste 1545
Sacramento, CA 95814
Title: Treasurer
Phone # (916) 254-5180

Treasurer:

FED Rebecca Olson
400 Capitol Mall, Ste 1545
Sacramento, California 95814
Title: Treasurer
Phone # (916) 254-5180

Designated Agent(s):

Kirk Alan Pessner
20 Park Rd, Ste E
Burlingame, California 94010
Title: Assistant Treasurer
Phone # (650) 401-8735

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-857993

1. Cooperative of American Physicians Federal Political Action Committee

2. Date: 02/15/2013

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Rebecca Olson
Date Signed: 02/15/2013

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-857993

1. Cooperative of American Physicians Federal Political Action Committee

2. Date: 02/15/2013

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Rebecca Olson Date Signed: 02/15/2013

(End FEC FORM 1)

Signed: Rebecca Olson
Date Signed: 02/15/2013