FEC Form 1 for American Academy of Dermatology Association Political Action CommitteeForm 1 for American Academy of Dermatology Association Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-185531

1. American Academy of Dermatology Association Political Action Committee

1350 I Street NW
Suite 880
Washington, DC 20005
Fax: 202-842-4355

2. Date: 08/30/2005

3. FEC Committee ID #: C00359539

Affiliated Committees/Organizations

Custodian of Records:

Phone # 0

Treasurer:

Donna Rebeck
930 E. Woodfield Road
Schaumburg, Illinois 60173
Phone # (847) 330-0230

Designated Agent(s):

Banks or Depositories

Signed: Donna Rebeck
Date Signed: 08/30/2005
Official Committee FAX: 202-842-4355

(End FEC FORM 1)

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