FEC Form 1 for POLITICAL ACTION COMMITTEE OF CRITICAL CARE SYSTEMS INTERNATIONAL INCForm 1 for POLITICAL ACTION COMMITTEE OF CRITICAL CARE SYSTEMS INTERNATIONAL INC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-465360

1. POLITICAL ACTION COMMITTEE OF CRITICAL CARE SYSTEMS INTERNATIONAL INC

6 Salmon Brook Drive
Attn: Tom McAndrews
NASHUA, NH 03062

NOTE: Address is different than previously reported

Email: tmcandrews4@gmail.com

NOTE: Email address is different than previously reported

2. Date: 04/22/2010

3. FEC Committee ID #: C00272864 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Critical Care Systems International
6 Salmon Brook Dr
Nashua, New Hampshire 03062
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Thomas John McAndrews
6 Salmon Brook Drive
Nashua, NH 03062
Phone # (603) 888-4686

Treasurer:

Thomas John McAndrews
6 Salmon Brook Drive
Nashua, New Hampshire 03062
Phone # (603) 888-4686

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-465360

1. POLITICAL ACTION COMMITTEE OF CRITICAL CARE SYSTEMS INTERNATIONAL INC

NOTE: Address is different than previously reported

NOTE: Email address is different than previously reported

2. Date: 04/22/2010

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Thomas John McAndrews
Date Signed: 04/22/2010

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-465360

1. POLITICAL ACTION COMMITTEE OF CRITICAL CARE SYSTEMS INTERNATIONAL INC

NOTE: Address is different than previously reported

NOTE: Email address is different than previously reported

2. Date: 04/22/2010

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Thomas John McAndrews Date Signed: 04/22/2010

(End FEC FORM 1)

Signed: Thomas John McAndrews
Date Signed: 04/22/2010