FEC Form 1 for GenesisCare USA Inc. Political Action CommitteeForm 1 for GenesisCare USA Inc. Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1636244

1. GenesisCare USA Inc. Political Action Committee

NOTE:Commmittee Name is different than previously reported

2270 Colonial Blvd.
Fort Myers, FL 33907
Email: kelly.duncan@quourm.us

NOTE: Email address is different than previously reported

2. Date: 10/10/2022

3. FEC Committee ID #: C00385120 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

GenesisCare USA, Inc.
2270 Colonial Blvd
Fort Myers, Florida 33907
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Kelly Duncan
One Thomas Circle
Washington, DC 20003
Title: Custodian of Records
Phone # (248) 941-7231

Treasurer:

Wy Louw
2270 Colonial Blvd.
Fort Myers, Florida 33907
Title: US Head of Finance a
Phone # (352) 494-2198

Designated Agent(s):

Banks or Depositories

Edison National Bank
13000 South Cleveland Ave
Fort Myers, Florida 33907

Signed: Wy Louw
Date Signed: 10/10/2022

FORM TEXT-1

(End FEC FORM 1)

Generated Wed Sep 18 07:12:46 2024