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FEC Form 1 for Beverly Enterprises Inc. Political Action Committee (Bev PAC)Form 1 for Beverly Enterprises Inc. Political Action Committee (Bev PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-35458

1. Beverly Enterprises Inc. Political Action Committee (Bev PAC)

    1250 H Street NW
    Suite 555
    Washington, DC 20005

2. Date: 06/24/1999

3. FEC Committee ID #: C00346346 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Beverly Enterprises Inc.
1000 Beverly Way
Fort Smith, Arkansas 72919
Relationship: Connected Organizations
Organization Type: Corporation

Custodian of Records:

Linda Cox
1250 H Street NW
Suite 555
Washington, DC 20005
Title: Treasurer
Phone # (202) 783-1115

Treasurer:

Linda Cox
1250 H Street NW
Suite 555
Washington, DC 20005
Title: Treasurer
Phone # (202) 783-1115

Designated Agent(s):

Banks or Depositories

SunTrust Bank
P. O. Box 85024
Richmond, Virginia 23285

Signed: Ms. Linda Kay Cox
Date Signed: 05/06/2002

(End FEC FORM 1)


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