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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1690061

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1. American Association of Nurse Anesthetists Separate Segregated Fund (CRNA-PAC)

    10275 W. Higgins Rd
    Suite 500 - c/o Finance Department
    Rosement, IL 60018
    Email: crnapacfec@aanadc.com

2. Date: 02/20/2023

3. FEC Committee ID #: C00173153 This committee is a separate segregated fund. Its connected organization is a Membership Organization
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

American Association of Nurse Anesthetists
10275 W. Higgins Rd
Suite 500
Park Ridge, Illinois 60018
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Eric Graunke
10275 W. Higgins Rd
Suite 500
Rosemont, IL 60018
Title: Controller

Treasurer:

Ingrida Lusis
25 Massachusetts Ave NW
Suite 320
Washington, DC 20019
Title: Deputy Chief Advocac
Phone # (202) 741-9066

Designated Agent(s):

Catharine Harris
25 Massachusetts Ave NW
Suite 320
Washington, DC 20002
Title: Director of Politica
Phone # (202) 741-9087

Banks or Depositories

Wintrust Bank, N.A.
231 S LaSalle
Floor 2
Chicago, Illinois 60604

Signed: Ingrida Lusis
Date Signed: 02/20/2023

FORM TEXT-1

(End FEC FORM 1)

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