FEC Form 1 for Assisted Living Federation of AmericaForm 1 for Assisted Living Federation of America

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-424388

1. Assisted Living Federation of America

1650 King Street
Suite 602
Alexandria, VA 22314
Email: mintermill@alfa.org

2. Date: 07/15/2009

3. FEC Committee ID #: C00338020 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

Assisted Living Federation of America
1650 King Street
Suite 602
Alexandria, Virginia 22314
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Micah Intermill
1650 King Street
Suite 602
Alexandria, VA 22314
Title: Director of Advocacy
Phone # (703) 562-1188

Treasurer:

Ms Maribeth Bersani
1650 King Street
Suite 602
Alexandria, Virginia 22314
Title: SVP Public Policy
Phone # (703) 562-1180

Designated Agent(s):

Banks or Depositories

SunTrust Bank
1445 New York Ave, NW
Washington, DC 20005

Signed: Ms Maribeth Bersani
Date Signed: 07/15/2009

(End FEC FORM 1)

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