FEC Form 1 for American College of Nurse Practitioners Political Action CommitteeForm 1 for American College of Nurse Practitioners Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-302143

1. American College of Nurse Practitioners Political Action Committee

1501 Wilson Blvd.
Suite 509
Arlington, VA 22209
Fax: 703-740-2538
Email: info@pacout.com

2. Date: 08/22/2007

3. FEC Committee ID #: C00382440 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

American College of Nurse Practitioners
1501 Wilson Blvd.
Suite 509
Arlington, Virginia 22209
Relationship: Connected
Organization Type: Trade Association

Custodian of Records:

PAC Outsourcing LLC
7915 Old Branch Avenue
First Floor
Clinton, MD 20735
Title: Custodian of Records
Phone # (301) 856-0770

Treasurer:

Wade S, Will
7915 Old Branch Avenue
First Floor
Clinton, Virginia 20735
Title: Treasurer
Phone # (301) 856-0770

Designated Agent(s):

Carolyn Hutcherson
1501 Wilson Blvd.
Suite 509
Arlington, Virginia 22209
Title: Assistant Treasurer
Phone # (703) 740-2533

Banks or Depositories

Bank of America
7810 Old Branch Avenue
Clinton, Maryland 20735

Signed: Wade S, Will
Date Signed: 08/22/2007
Official Committee FAX: 703-740-2538

(End FEC FORM 1)

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