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-346776

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

1760 Old Meadow Road
Suite 500
McLean, VA 22102

NOTE: Address is different than previously reported

Fax: 7035063266
Email: None

2. Date: 07/01/2008

3. FEC Committee ID #: C00388470 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Emergency Department Practice Management Association
1760 Old Meadow Road
Suite 500
McLean, Virginia 22102
Affiliated Relationship Code: Connected Organization

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
200 Corporate Boulevard
Suite 201
Lafayette, Louisiana 70508
Title: Treasurer
Phone # (337) 354-1102

Designated Agent(s):

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

Banks or Depositories

PNC Bank
6805 Old Dominion Drive
McLean, Virginia 22101

Signed: Leslie J. Kerman
Date Signed: 07/01/2008
Official Committee URL: None
Official Committee FAX: 7035063266

(End FEC FORM 1)

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