FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-70527
1. Mariner Health Care Inc. Federal Political Action Committee
NOTE:Commmittee Name is different than previously reported
One Ravinia DriveSuite 1500
Atlanta, GA 30346
2. Date: 10/26/1998
3. FEC Committee ID #: C00294371 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Mariner Health Care Inc.1 Ravinia Drive
Suite 1500
Atlanta, Georgia 30346
Relationship: Connected Organizations
Organization Type: Corporation
Custodian of Records:
William Straub1 Ravinia Drive
Suite 1500
Atlanta, GA 30346
Title: Treasurer
Treasurer:
William Straub1 Ravinia Drive
Suite 1500
Atlanta, Georgia 30346
Title: Treasurer
Designated Agent(s):
Cynthia Rifkin1 Ravinia Drive
Suite 1500
Atlanta, Georgia 30346
Title: Assistant Treasurer
Banks or Depositories
Bank of America500 N. Akard
Dallas, Texas 75283