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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1014037

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1. American Psychiatric Association Political Action Committee

    1000 Wilson Blvd.
    Suite 1825
    Arlington, VA 22209
    Email: amild@psych.org

    NOTE: Email address is different than previously reported

2. Date: 07/14/2015

3. FEC Committee ID #: C00373696 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 Psychiatric Association
1000 Wilson Blvd.
Suite 1825
Arlington, Virginia 22209
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Ashley Mild
1000 Wilson Blvd.
Suite 1825
Arlington, VA 22209
Title: Treasurer
Phone # (703) 907-8645

Treasurer:

Ashley Mild
1000 Wilson Blvd.
Suite 1825
Arlington, Virginia 22209
Title: Treasurer
Phone # (703) 907-8645

Designated Agent(s):

Scott Barnes
1000 Wilson Blvd
Suite 1825
Arlington, Virginia 22209
Title: Assistant Treasurer
Phone # (703) 907-7800

Banks or Depositories

Bank of America
730 15th Street, NW
Washington, DC 22205

Signed: Ashley Mild
Date Signed: 07/14/2015

(End FEC FORM 1)

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