FEC Form 1 for American Association of Nurse Anesthetists Separate Segregated Fund (CRNA-PAC)Form 1 for American Association of Nurse Anesthetists Separate Segregated Fund (CRNA-PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-306444

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

222 South Prospect Ave
c/o Finance Department
Park Ridge, IL 600684001
Fax: 847-685-4503
Email: crnapacfec@aanadc.com

2. Date: 02/12/2007

3. FEC Committee ID #: C00173153 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

American Association of Nurse Anesthetists
222 South Prospect Ave
Park Ridge, Illinois 600684001
Relationship: Connected
Organization Type: Membership Organization

Custodian of Records:

Jan Benjamin
222 South Prospect Avenue
c/o Finance Department
Park Ridge, IL 60068
Title: Controller

Treasurer:

William Yeo
222 South Prospect Ave
c/o Finance Department
Park Ridge, Illinois 600684001
Title: Senior Director Fin
Phone # (847) 692-7050

Designated Agent(s):

Frank Purcell
412 First St SE #12
Washington, DC 20003
Title: Sr Dir Fed Gov Affrs
Phone # (202) 484-8400

Banks or Depositories

JP Morgan Chase Bank NA
120 S. LaSalle Street
Chicago, Illinois 60603

DWS Scudder
210 West 10th Street
6th Floor
Kansas City, Missouri 64105

Signed: William Yeo
Date Signed: 02/16/2007
Official Committee FAX: 847-685-4503

FORM TEXT

(End FEC FORM 1)

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