FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-142843
1. HEALTH CARE LEADERSHIP COMMITTEE
221 EAST CAPITOL AVENUEJEFFERSON CITY, MO 65101
NOTE: Address is different than previously reported
Fax: 5738937793Email: shawk@lewisrice.com
2. Date: 09/17/2004
3. FEC Committee ID #: C00323576This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
Affiliated Committees/Organizations
Custodian of Records:
Shanon Hawk
221 E. Capitol Avenue
Jefferson City, MO 65101
Title: Deputy Treasurer
Phone # (573) 893-7753
Treasurer:
Leann Chilton
6805 Kimmswick Court
Oak Village, Missouri 63129
Title: Treasurer
Phone # (314) 846-3057
Designated Agent(s):
Jonathan Dalton
221 East Capitol Avenue
Jefferson City, Missouri 65101
Title: President
Phone # (573) 893-7748
Banks or Depositories
US Bank
11685 Gravois Road
St. Louis, Missouri 63126
Signed: Leann Chilton
Date Signed: 10/19/2004
Official Committee FAX: 5738937793
(End FEC FORM 1)
Date Signed: 10/19/2004
Official Committee FAX: 5738937793