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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-113760

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1. American Pharmacists Association Political Action Committee

    2215 Constitution Avenue NW
    Washington, DC 20037
    Fax: 202-638-3793
    Email: PAC@aphanet.org

2. Date: 04/01/2004

3. FEC Committee ID #: C00193854 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Timothy A. Barrick
1104 W MacArthur St
Shawnee, Oklahoma 74804
Title: Chair/Treasurer
Phone # (405) 273-8717

Designated Agent(s):

Banks or Depositories

Signed: Roger K. Browning
Date Signed: 04/06/2004
Official Committee URL: www.aphanet.org
Official Committee FAX: 202-638-3793

(End FEC FORM 1)

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