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-956665

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

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

2. Date: 10/14/2014

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

Affiliated Committees/Organizations

Joan American Dental Hygienists' Association
444 N Michigan Ave
Suite 3400
Chicago, Illinois 60611
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Spencer Williams
444 N. Michigan Avenue
Suite 3400
Chicago, IL 60611
Title: Governmental Affairs
Phone # (312) 440-8940

Treasurer:

Joan Fitzgerald
69 Lancelot Avenue
Manchester, New Hampshire 03104
Title: Treasurer
Phone # (603) 623-6569

Designated Agent(s):

Jose Rodriguez
444 N Michigan Ave
Suite 3400
Chicago, Illinois 60611
Title: Assistant Treasurer
Phone # (312) 440-8914

Banks or Depositories

US Bank
444 N Michigan Ave Suite 3400
Chicago, Illinois 606113980

Signed: Joan Fitzgerald
Date Signed: 10/14/2014

FORM TEXT

(End FEC FORM 1)

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