FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-1150673
1. Genesis Healthcare Inc PAC
101 EAST STATE STREETKENNETT SQUARE, PA 19348
Email: James.Tabak@Genesishcc.com;Laurence.Lane@Genesishcc.com
NOTE: Email address is different than previously reported
2. Date: 02/23/2017
3. FEC Committee ID #: C00292094 This committee is a separate segregated fund. Its connected organization is a CorporationIn addition, this committee is a Lobbyist/Registrant PAC.
Affiliated Committees/Organizations
Committee ID# C00292094Genesis Healthcare Inc.
101 East State Street
Kennett Square, Pennsylvania 19348
Affiliated Relationship Code: Connected Organization
Custodian of Records:
James W Tabak105 Marlbrooke Way
Kennett Square, PA 19348
Treasurer:
James W Tabak105 Marlbrooke Way
Kennett Square, Pennsylvania 19348
Designated Agent(s):
Banks or Depositories
Wells Fargo Bank400 Scarlett Road
Kennett Square, Pennsylvania 19348