FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-213726
1. Prison Health Services Inc. Political Action Committee
105 Westpark Drive Suite 200Brentwood, TN 37027
2. Date: 04/10/2006
3. FEC Committee ID #: C00345496 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Prison Health Services Inc.105 Westpark Drive
Suite 200
Brentwood, Tennessee 37027
Relationship: Connected Organization
Organization Type: Corporation
Custodian of Records:
PAC Services LLC7700 Old Branch Avenue
Suite D-103
Clinton, MD 20735
Title: Custodian of Records
Phone # (301) 868-1888
Treasurer:
Thomas West105 Westpark Drive
Suite 200
Brentwood, Tennessee 37027
Title: PAC Treasurer
Phone # (615) 376-0655
Designated Agent(s):
Banks or Depositories
Bank of AmericaOne Bank of America Plaza
Nashville, Tennessee 372391697