FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-310141
1. American Association of Physician Specialists Inc. Politician Action Committee (AAPSPAC)
5550 W. Executive Drive Suite 400Tampa, FL 33609
Email: bshuford@aapsus.org
2. Date: 11/06/2007
3. FEC Committee ID #: C00331017 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Custodian of Records:
William J. Carbone5550 Executive Dr Suite 400
Tampa, FL 33609
Title: Custodian
Treasurer:
Stephen Montes701 West Wedgewood
Muskegon, Michigan 49445
Title: Treasurer
Phone # (616) 773-3238
Designated Agent(s):
Steven Carin40 Grosvenor Hall
Athens, Ohio 45701
Title: Assistant Treasurer
Phone # (740) 594-4722
Banks or Depositories
Bank of AmericaPO Box 25118
Tampa, Florida 33622