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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-123743

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1. California Nurses Association PAC - Federal

    NOTE:Commmittee Name is different than previously reported

    555 Capitol Mall Suite 1425
    Sacramento, CA 95814

2. Date: 06/02/2004

3. FEC Committee ID #: C00360438 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

CA Nurses Association
2000 Franklin Street
Oakland, California 94612
Relationship: Connected Organization
Organization Type: Labor Organization

Custodian of Records:

Lance H. Olson
555 Capitol Mall Suite 1425
Sacramento, CA 95814
Title: Attorney

Treasurer:

Malinda Markowitz
5899 Paddon Circle
San Jose, California 95123
Title: Treasurer
Phone # (408) 224-1274

Designated Agent(s):

Banks or Depositories

U.S. Bank
980 9th Street
Sacramento, California 95814

Signed: Malinda Markowitz
Date Signed: 06/17/2004

(End FEC FORM 1)

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