FEC Form 1 for AMERICAN ASSOCIATION OF CLINICAL UROLOGISTS PAC (UROPAC)Form 1 for AMERICAN ASSOCIATION OF CLINICAL UROLOGISTS PAC (UROPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1039865

1. AMERICAN ASSOCIATION OF CLINICAL UROLOGISTS PAC (UROPAC)

NOTE:Commmittee Name is different than previously reported

P.O. Box 15441
Washington, DC 20003
Email: info@uropac.org;outsourcing@aristotle.com

2. Date: 01/04/2016

3. FEC Committee ID #: C00273003 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

American Association Of Clinical Urologists
1100 E Woodfield Rd
Ste 520
Schaumburg, Illinois 601735125
Affiliated Relationship Code: Connected Organization

Custodian of Records:

David Mason
PO Box 15441
Washington, DC 200030441
Title: Custodian of Records
Phone # (202) 543-8345

Treasurer:

Dr. Robert Andrews Bass
3311 Prescott Rd
Ste 100
Alexandria, Louisiana 713013917
Title: Treasurer
Phone # (318) 880-3263

Designated Agent(s):

David Mason
PO Box 15441
Washington, DC 200030441
Title: Assistant Treasurer
Phone # (202) 543-8345

Banks or Depositories

BB&T
317 Pennsylvania Ave. SE
Washington, DC 20003

Signed: Dr. Robert Andrews Bass
Date Signed: 01/14/2016
Official Committee URL: uropac.org

FORM TEXT-1

(End FEC FORM 1)

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