FEC Form 1 for AMERICAN HEALTH QUALITY ASSOCIATION POLITICAL ACTION COMMITTEE (AHQA-PAC)Form 1 for AMERICAN HEALTH QUALITY ASSOCIATION POLITICAL ACTION COMMITTEE (AHQA-PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-410194

1. AMERICAN HEALTH QUALITY ASSOCIATION POLITICAL ACTION COMMITTEE (AHQA-PAC)

1155 21st Street, NW
Suite 202
WASHINGTON, DC 20036
Email: behrle@ahqa.org

2. Date: 03/27/2009

3. FEC Committee ID #: C00370213 This committee is a separate segregated fund. Its connected organization is a Trade Association
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

American Health Quality Association
1155 21st Street, NW
Suite 202
Washington, DC 20036
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Bruce Ehrle
1155 21st Street, NW
Suite 202
Washington, DC 20036
Title: Dir. Gov't Affairs
Phone # (202) 331-5790

Treasurer:

Bruce Ehrle
1155 21st Street, NW
Suite 202
Washington, DC 20036
Title: Dir. Gov't Affairs
Phone # (202) 331-5790

Designated Agent(s):

Bruce Ehrle
1155 21st Street, NW
Suite 202
Washington, DC 20036

Banks or Depositories

United Bank
1667 K Street, NW
Washington, DC 20006

Signed: Bruce Ehrle
Date Signed: 03/27/2009

(End FEC FORM 1)

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