FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-859655
1. Delta Dental Plans Association PAC
1515 W. 22ND STREET, SUITE 450OAK BROOK, IL 60523
Email: jgrant@deltadental.com;ktrainer@wileyrein.com
NOTE: Email address is different than previously reported
2. Date: 03/08/2013
3. FEC Committee ID #: C00213819 This committee is a separate segregated fund. Its connected organization is a Trade AssociationIn addition, this committee is a Lobbyist/Registrant PAC.
Affiliated Committees/Organizations
Delta Dental Plans Association1515 W 22nd Street
Suite 450
Oak Brook, Illinois 60523
Affiliated Relationship Code: Connected Organization
Custodian of Records:
Ben Yomtoob1515 W 22nd Street
Suite 450
Oak Brook, IL 60523
Title: Treasurer
Treasurer:
Ben Yomtoob1515 W 22nd Street
Suite 450
Oak Brook, Illinois 60523
Title: Treasurer
Designated Agent(s):
Robert Reese1515 22nd Street
Suite 450
Oak Brook, Illinois 60523
Title: Assistant Treasurer
Phone # (630) 574-6852
Banks or Depositories
The Northern Trust Company50 S. LaSalle Street
Chicago, Illinois 60675
Delaware Place Bank
190 E. Delaware Place
Chicago, Illinois 60611