FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-490810
1. GENESIS HEALTHCARE CORPORATION POLITICAL ACTION COMMITTEE
101 EAST STATE STREETKENNETT SQUARE, PA 19348
Email: Laurence.Lane@genesishcc.com
2. Date: 08/31/2010
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
Genesis HealthCare Corporation101 E. State Street
Kennett Square, Pennsylvania 19348
Affiliated Relationship Code: Connected Organization
Custodian of Records:
LAURENCE F. LANE1616 STEPHENS DRIVE
WAYNE, PA 19087
Title: VP Government Relati
Phone # (610) 444-8430
Treasurer:
LAURENCE F. LANE1616 STEPHENS DRIVE
WAYNE, Pennsylvania 19087
Title: VP Gov. Relations
Phone # (610) 444-8430
Designated Agent(s):
Banks or Depositories
Wachovia Bank400 Scarlett Road
Kennett Square, Pennsylvania 19348