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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-782921

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1. Kidney Care Council Political Action Committee

    1760 Old Meadow Road
    Suite 500
    McLean, VA 22102

    NOTE: Address is different than previously reported

    Email: ccepriano@kidneycarecouncil.org

2. Date: 05/11/2012

3. FEC Committee ID #: C00326736 This committee is a separate segregated fund. Its connected organization is a Trade Association
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Kidney Care Council
1760 Old Meadow Road
Suite 500
McLean, Virginia 22102
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Cherilyn Cepriano
1760 Old Meadow Road
Suite 500
McLean, VA 22102
Title: Custodian of Records
Phone # (202) 744-2124

Treasurer:

Cherilyn Cepriano
1760 Old Meadow Road
Suite 500
McLean, Virginia 22102
Title: Treasurer
Phone # (202) 744-2124

Designated Agent(s):

Regina Sherick
The Atlantic Building
950 F Street, NW
Washington, DC 20004
Title: Assistant Treasurer
Phone # (202) 756-3300

Banks or Depositories

United Bank
1275 Pennsylvania Avenue NW
Washington, DC 20004

Signed: Cherilyn Cepriano
Date Signed: 05/11/2012

(End FEC FORM 1)

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