FEC Form 1 for American College of Nurse-Midwives Midwives-PACForm 1 for American College of Nurse-Midwives Midwives-PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-86339

1. American College of Nurse-Midwives Midwives-PAC

P. O. Box 14082
Washington, DC 200444082

NOTE: Address is different than previously reported

Fax: 212-995-4384
Email: N/A

2. Date: 06/04/2003

3. FEC Committee ID #: C00358812 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

American College of Nurse-Midwives
818 Connecticut Avenue NW
Suite 900
Washington, DC 20006
Relationship: Connected
Organization Type: Membership Organization

Custodian of Records:

PACS
7700 Old Branch Avenue
Suite D-103
Clinton, MD 20735
Phone # (301) 868-1888

Treasurer:

Patricia Burkhardt
246 Greene Street
New York, New York 10003
Title: Midwifery Educator
Phone # (212) 998-5039

Designated Agent(s):

Karen Fennell
818 Connecticut Avenue NW
Suite 900
Washington, DC 20006
Title: Senior PolicyAnalyst
Phone # (202) 728-9860

Banks or Depositories

Bank of America
7810 Old Branch Avenue
Clinton, Maryland 20735

Signed: Patricia Burkhardt
Date Signed: 06/04/2003
Official Committee URL: N/A
Official Committee FAX: 212-995-4384

(End FEC FORM 1)

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