FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-134308
1. AMERICAN SOCIETY OF ANESTHESIOLOGISTS POLITICAL ACTION COMMITTEE
520 N. NORTHWEST HIGHWAYPARK RIDGE, IL 60068
Fax: 8478251692
Email: R.BARWACZ@ASAHQ.ORG
2. Date: 09/10/2004
3. FEC Committee ID #: C00255752 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Custodian of Records:
RONALD BRUNS520 N NORTHWEST HWY
PARK RIDGE, IL 60068
Title: EXECUTIVE DIRECTOR
Phone # (847) 825-5586
Treasurer:
RICHARD BARWACZ520 N NORTHWEST HIGHWAY
PARK RIDGE, Illinois 60068
Title: DIRECTOR OF FINANCE
Phone # (847) 825-5586