FEC Form 1 for American Academy of Pediatric Dentistry Political Action CommitteeForm 1 for American Academy of Pediatric Dentistry Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-259625

1. American Academy of Pediatric Dentistry Political Action Committee

211 E Chicago Ave
Suite 700
Chicago, IL 606112663

NOTE: Address is different than previously reported

Fax: 3123376329
Email: jrutkauskas@aapd.org

2. Date: 11/22/2006

3. FEC Committee ID #: C00365965 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

, ____

Designated Agent(s):

Dr. Elliott D. Maser
3101 Bristol Road #1
Bensalem, Pennsylvania 19020
Title: Assistant Treasurer

Banks or Depositories

Signed: John S. Rutkauskas
Date Signed: 11/22/2006
Official Committee URL: www.aapd.org
Official Committee FAX: 3123376329

(End FEC FORM 1)

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