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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1335101

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1. American Society of Health System Pharmacist - PAC

    4500 East-West Highway Suite 900
    Bethesda, MD 20814
    Email: gad@ashp.org

2. Date: 06/17/2019

3. FEC Committee ID #: C00245530 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 Society of Helath System Pharmacists
4500 East-West Highway Suite 900
Bethesda, Maryland 20814
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Thomas Kraus
4500 East West Hwy
Suite 900
Bethesda, Maryland 20814
Title: Treasurer
Phone # (301) 664-8692

Designated Agent(s):

Thomas Kraus
4500 East West Hwy
Suite 900
Bethesda, Maryland 20814
Title: Treasurer
Phone # (301) 664-8693

John Heberlein
4500 East West HWY
Bethesda, Maryland 20008
Title: Assistant Treasurer
Phone # (301) 664-8692

Banks or Depositories

Capital One Bank
10700 Capital One Way
Glenn Allen, Virginia 23030

Signed: Thomas Kraus
Date Signed: 06/20/2019

(End FEC FORM 1)

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