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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1362624

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1. Arizona Orthopaedic Society Politial Action Committee

    2401 W. Peoria Avenue
    Ste. 130
    Phoenix, AZ 85029

    NOTE: Address is different than previously reported

    Email: patrice@azmed.org

    NOTE: Email address is different than previously reported

2. Date: 12/06/2006

3. FEC Committee ID #: C00279836 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

David Ott
333 W. Thomas Rd. A
Phoenix, AZ 85013

Treasurer:

David Ott
333 W. Thomas Rd. A
Phoenix, Arizona 85013

Designated Agent(s):

Banks or Depositories

Chase
1761 W. Baseline Road
Mesa, Arizona 85202

Signed: David Ott
Date Signed: 11/14/2019

(End FEC FORM 1)

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