FEC Form 1 for AMERICAN ACADEMY OF OTOLARYNGOLOGY-HEAD AND NECK SURGERY ENT PACForm 1 for AMERICAN ACADEMY OF OTOLARYNGOLOGY-HEAD AND NECK SURGERY ENT PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-998794

1. AMERICAN ACADEMY OF OTOLARYNGOLOGY-HEAD AND NECK SURGERY ENT PAC

1650 Diagonal Road
Alexandria, VA 22314
Email: mmarcinko@entnet.org

2. Date: 03/20/2015

3. FEC Committee ID #: C00306449 This committee is a separate segregated fund. Its connected organization is a Membership Organization
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

American Academy of Otolaryngology - Head and Neck Surgery ENT PAC
1650 Diagonal Road
Alexandria, Virginia 22314
Affiliated Relationship Code: Connected Organization

Custodian of Records:

James C. Denneny III,, MD
1650 Diagonal Road
Alexandria, VA 22314
Title: EVP/CEO
Phone # (703) 836-4444

Treasurer:

James C. Denneny III,, MD
1650 Diagonal Road
Alexandria, Virginia 22314
Title: EVP/CEO
Phone # (703) 836-4444

Designated Agent(s):

Carrie Hanlon,, CPA
1650 Diagonal Road
Alexandria, Virginia 22314
Title: Sr. Director
Phone # (703) 836-4444

Banks or Depositories

National Capital Bank of Washington
316 Pennsylvania Ave, SE
Washington, DC 20003

Signed: James C. Denneny III,, MD
Date Signed: 03/20/2015

FORM TEXT-1

(End FEC FORM 1)

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