FEC Form 1 for NEW YORK STATE ASSOCIATION OF HEALTH CARE PROVIDERS INC FEDERAL PAC (HCP FEDERAL PAC)Form 1 for NEW YORK STATE ASSOCIATION OF HEALTH CARE PROVIDERS INC FEDERAL PAC (HCP FEDERAL PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1024919

1. NEW YORK STATE ASSOCIATION OF HEALTH CARE PROVIDERS INC FEDERAL PAC (HCP FEDERAL PAC)

20 Corporate Woods Blvd.,
2nd Floor
Albany, NY 122112370
Email: dworakowski@nyshcp.org

2. Date: 09/16/2015

3. FEC Committee ID #: C00307637 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Committee ID# C00307637
NEW YORK STATE ASSOCIATION OF HEALTH CARE PROVIDERS INC FEDERAL PAC (HCP FEDERAL PAC)
20 Corporate Woods Blvd.,
2nd Floor
Albany, New York 122112370
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Amy L. Thomas
469 West 57th Street, 2D
New York, New York 10019
Title: Treasurer
Phone # (646) 279-4657

Designated Agent(s):

Banks or Depositories

Pioneer Bank
21 Second Street
Troy, New York 12180

Signed: Claudia J. Hammar, Asst. Treasurer
Date Signed: 09/16/2015

(End FEC FORM 1)

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