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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1018744

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1. GGNSC Holdings LLC/Golden Horizons Care PAC

    700 13th Street, NW
    2nd Floor
    Washington, DC 20005
    Email: GoldenHorizonsCarePAC@myfecnotices.com

2. Date: 07/20/2015

3. FEC Committee ID #: C00346346 This committee is a separate segregated fund. Its connected organization is a Corporation
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

GGNSC Holdings LLC/Golden Horizons Care
1000 Fianna Way
Fort Smith, Arizona 72919
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Political Action Committee Services
18 Irongate Drive
Unit 10
Waldorf, MD 20602
Title: Director
Phone # (301) 645-0215

Treasurer:

Stacie E.S. Aman
700 13th Street, NW
2nd Floor
Washington, DC 20005
Title: Gov't Relations
Phone # (202) 434-0490

Designated Agent(s):

Stacie Smith
1000 Fianna Way
Fort Smith, Arkansas 72919
Title: Assistant Treasurer
Phone # (479) 201-5564

Belinda Marcotte
1000 Fianna Way
Ft. Smith, Arkansas 72919
Title: Assistant Treasurer
Phone # (479) 201-5564

Banks or Depositories

Sun Trust Bank
1100 G Street NW
Washington, DC 20005

Signed: Stacie E.S. Aman
Date Signed: 07/20/2015

(End FEC FORM 1)

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