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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-39829

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1. California Association of Nurse Practitioners Federal

    1127-11th Street Suite 300
    Sacramento, CA 95814

2. Date: 06/19/2002

3. FEC Committee ID #: C00360768 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

CA Association of Nurse Practitioners
2300 Bethards Drive Suite K
Santa Rosa, California 95405
Relationship: CA Association of Nurse Practitioners
Organization Type: Corporation

Custodian of Records:

J. Richard Eichman
1127-11th Street Suite 300
Sacramento, CA 95814
Title: CST
Phone # (916) 442-2280

Treasurer:

J. Richard Eichman
1127-11th Street Suite 300
Sacramento, California 95814
Title: Treasurer
Phone # (916) 442-2280

Designated Agent(s):

Banks or Depositories

Signed: J. Richard Eichman
Date Signed: 06/19/2002

(End FEC FORM 1)

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