FEC Form 1 for Emergency Department Practice Management Association PAC (EDPMA-PAC)Form 1 for Emergency Department Practice Management Association PAC (EDPMA-PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-175727

1. Emergency Department Practice Management Association PAC (EDPMA-PAC)

8405 Greensboro Drive
Suite 800
McLean, VA 221025120

2. Date: 06/03/2005

3. FEC Committee ID #: C00388470 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Emergency Department Practice Management Association
8405 Greensboro Drive
Suite 800
McLean, Virginia 221025120
Relationship: Connected Organiz.
Organization Type: Trade Association

Custodian of Records:

Leslie J. Kerman
6849 Old Dominion Drive
Suite 222
McLean, VA 22101
Title: Assistant Treasurer
Phone # (571) 633-9741

Treasurer:

William C. Schumacher
2439 Highway 754
Sunset, Louisiana 70584
Title: Treasurer
Phone # (337) 237-1915

Designated Agent(s):

Leslie J. Kerman
6849 Old Dominion Drive
Suite 222
McLean, Virginia 22101
Title: Assistant Treasurer
Phone # (571) 633-9741

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-175727

1. Emergency Department Practice Management Association PAC (EDPMA-PAC)

2. Date: 06/03/2005

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Leslie J. Kerman
Date Signed: 06/03/2005

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-175727

1. Emergency Department Practice Management Association PAC (EDPMA-PAC)

2. Date: 06/03/2005

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Leslie J. Kerman Date Signed: 06/03/2005

(End FEC FORM 1)

Signed: Leslie J. Kerman
Date Signed: 06/03/2005