FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-1028065
1. American Association of Physician Specialists Inc. Politician Action Committee (AAPSPAC)
5550 W. Executive Drive Suite 400Tampa, FL 33609
Email: jmorris@aapsus.org;apollo1113@aol.com
NOTE: Email address is different than previously reported
2. Date: 10/14/2015
3. FEC Committee ID #: C00331017 This committee is a separate segregated fund. Its connected organization is a Membership OrganizationAffiliated Committees/Organizations
American Association of Physician Specialists Inc.5550 W. Executive Drive Suite 400
Tampa, Florida 33609
Affiliated Relationship Code: Connected Organization
Custodian of Records:
William J. Carbone5550 Executive Dr Suite 400
Tampa, FL 33609
Title: Custodian
Treasurer:
Mark DeSantis DO353 Martin Dr
West Islip, New York 117952003
Title: Treasurer
Phone # (516) 707-4574
Designated Agent(s):
Surinder Kad1519 Lake Shore Cir
Crestwood, Kentucky 40014
Phone # (859) 533-1385
Banks or Depositories
Bank Of Tampa4400 North Armenia Avenue
PO Box 1
Tampa, Florida 33601