FEC Form 1 for American Dental Hygienists' Association Political Action Committee (HYPAC)Form 1 for American Dental Hygienists' Association Political Action Committee (HYPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-473214

1. American Dental Hygienists' Association Political Action Committee (HYPAC)

444 N. Michigan
Suite 3400
Chicago, IL 606113980
Email: hypac@adha.net

NOTE: Email address is different than previously reported

2. Date: 06/02/2010

3. FEC Committee ID #: C00345868 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

American Dental Hygienists' Association
444 N Michigan Avenue Suite 3400
Chicago, Illinois 606113980
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Stacey Chappell
444 N. Michigan Avenue
Suite 3400
Chicago, IL 60611
Title: Governmental Affairs
Phone # (312) 440-8914

Treasurer:

Denise B Bowers
3710 Doe Court
Lima, Ohio 45807
Title: Treasurer
Phone # (419) 230-4199

Designated Agent(s):

Stacey Chappell
444 N Michigan Ave Suite 3400
Chicago, Illinois 606113980
Title: Assistant Treasurer
Phone # (312) 440-8914

Banks or Depositories

US Bank
P O Box 1800
St. Paul, Minnesota 551010800

Signed: Denise B Bowers
Date Signed: 06/02/2010
Official Committee URL: http://hypac.adha.org

NOTE: URL is different than previously reported

(End FEC FORM 1)

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