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-429645

1. CLINICAL LABORATORY MANAGEMENT ASSOCIATION POLITICAL ACTION COMMITTEE

993 OLD EAGLE SCHOOL ROAD
SUITE 405
WAYNE, PA 190871704
Email: jwisniewski@clma.org

2. Date: 05/27/2009

3. FEC Committee ID #: C00381152 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Joseph Wisniewski
1301 Sunny Hill Lane
Havertown, PA 19083
Title: Assistant Treasurer
Phone # (610) 995-9580

Treasurer:

Martha Casassa
10 Norroway Avenue
Randolph, Massachusetts 023683013
Title: Treasurer
Phone # (781) 348-2068

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-429645

1. CLINICAL LABORATORY MANAGEMENT ASSOCIATION POLITICAL ACTION COMMITTEE

2. Date: 05/27/2009

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Martha Casassa
Date Signed: 08/14/2009

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-429645

1. CLINICAL LABORATORY MANAGEMENT ASSOCIATION POLITICAL ACTION COMMITTEE

2. Date: 05/27/2009

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Martha Casassa Date Signed: 08/14/2009

(End FEC FORM 1)

Signed: Martha Casassa
Date Signed: 08/14/2009