FEC Form 1 for CLINICAL LABORATORY MANAGEMENT ASSOCIATION POLITICAL ACTION COMMITTEEForm 1 for CLINICAL LABORATORY MANAGEMENT ASSOCIATION POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-177276

1. CLINICAL LABORATORY MANAGEMENT ASSOCIATION POLITICAL ACTION COMMITTEE

989 OLD EAGLE SCHOOL ROAD
SUITE 815
WAYNE, PA 190871704
Fax: 6109959568
Email: jwisniewski@clma.org

2. Date: 05/18/2005

3. FEC Committee ID #: C00381152 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Clinical Laboratory Management Assoc Inc
989 Old Eagle School Road
Suite 815
Wayne, Pennsylvania 190871704
Organization Type: Membership Organization

Custodian of Records:

Treasurer:

Patricia Ehrhardt
26 Cub Drive
Great Falls, Montana 59404

Designated Agent(s):

Joseph Wisniewski
1301 Sunny Hill Lane
Havertown, Pennsylvania 19083

Banks or Depositories

Signed: Patricia Ehrhardt
Date Signed: 06/22/2005
Official Committee FAX: 6109959568

(End FEC FORM 1)

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