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FEC Form 1 for VHA Inc., Political Action CommitteeForm 1 for VHA Inc., Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1004365


1. VHA Inc., Political Action Committee

    799 9th Street, N.W.
    Suite 210
    Washington, DC 20001

    NOTE: Address is different than previously reported

    Email: scarruth@vha.com

2. Date: 04/16/2015

3. FEC Committee ID #: C00199497 This committee is a separate segregated fund. Its connected organization is a Corporation
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

VHA -UHC Alliance NewCo, Inc.
290 E. John Carpenter Freeway
Irving, Texas 75062
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Edward Goodman
799 9th Street
Suite 210
Washington, DC 20001
Title: Vice President
Phone # (202) 354-2607

Treasurer:

Edward Goodman
799 9th Street
Suite 210
Washington, DC 20001
Title: Vice President
Phone # (202) 354-2607

Designated Agent(s):

Cidette Perrin
799 9th Steet, N.W.
Suite 210
Washington, DC 20001
Title: Senior Director
Phone # (202) 354-2608

Banks or Depositories

The Northern Trust Company
P.O. Box 92000
Chicago, Illinois 606752000

Signed: Edward Goodman
Date Signed: 04/16/2015

(End FEC FORM 1)


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