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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-281043

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1. PlastyPAC

    444 E. Algonquin
    Arlington Heights, IL 60005
    Fax: 2023371207
    Email: kc@plasticsurgery.org

2. Date: 03/15/2007

3. FEC Committee ID #: C00249342 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

, ____

Designated Agent(s):

Banks or Depositories

Signed: William Seward
Date Signed: 03/15/2007
Official Committee FAX: 2023371207

(End FEC FORM 1)

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