FEC Form 1 for eyePAC Political Action Committee for American Society of Cataract and Refractive SurgeryForm 1 for eyePAC Political Action Committee for American Society of Cataract and Refractive Surgery

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-161207

1. eyePAC Political Action Committee for American Society of Cataract and Refractive Surgery

4000 Legato Road
Suite 850
Fairfax, VA 220334003

2. Date: 10/01/1983

3. FEC Committee ID #: C00171504 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

American Society of Cataract & Refractive Surgery
4000 Legato Road Suite 850
Fairfax, Virginia 22033
Relationship: Connected Organization
Organization Type: Membership Organization

Custodian of Records:

Suzanne Peeler
4000 Legato Road Suite 850
Fairfax, VA 22033
Title: Treasurer

Treasurer:

Suzanne Peeler
4000 Legato Road Suite 850
Fairfax, Virginia 22033
Title: Treasurer

Designated Agent(s):

Nancey McMann
4000 Legato Road Suite 850
Fairfax, Virginia 22033
Title: Asst Treasurer

Banks or Depositories

Suntrust Bank
1445 New York Avenue NW
Washington, DC 20005

Dean Witter Reynolds
2 Wisconsin Circle
Suite 330
Chevy Chase, Maryland 20815

Signed: Suzanne S. Peeler
Date Signed: 01/27/2005

(End FEC FORM 1)

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