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-1131959

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: 12/08/2016

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:

James P Rolla
12 Deepdale Dr.
Commack, New York 11725
Title: Treasurer
Phone # (516) 433-2600

Designated Agent(s):

Claudia J Hammer
108 Tompion Way
Ballston Spa, New York 12020
Title: Asst. Treasurer
Phone # (518) 463-1118

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1131959

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

2. Date: 12/08/2016

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Claudia J Asst. Treasurer Hammar
Date Signed: 12/08/2016

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1131959

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

2. Date: 12/08/2016

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Claudia J Asst. Treasurer Hammar Date Signed: 12/08/2016

(End FEC FORM 1)

Signed: Claudia J Asst. Treasurer Hammar
Date Signed: 12/08/2016