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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1320459

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1. Ardent Legacy Holdings LLC Good Government Fund

    NOTE:Commmittee Name is different than previously reported

    One Burton Hills Boulevard
    Suite 250
    Nashville, TN 37215
    Email: Ashley.Crabtree@ardenthealth.com

2. Date: 03/20/2019

3. FEC Committee ID #: C00390963 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Ardent Legacy Holdings LLC
One Burton Hills Boulevard
Suite 250
Nashville, Tennessee 37215
Affiliated Relationship Code: Connected Organization

Ardent Legacy Holdings LLC Federal PAC
One Burton Hills Boulevard
Suite 250
Nashville,, Tennessee 37215
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Mrs. Ashley M. Crabtree
4200 Belmont Boulevard
Nashville,, TN 37215
Title: Treasurer
Phone # (615) 296-3202

Treasurer:

Mrs. Ashley M. Crabtree
4200 Belmont Boulevard
Nashville,, Tennessee 37215
Title: Treasurer
Phone # (615) 296-3202

Designated Agent(s):

Stephen C. Petrovich
9013 Brentmeade Boulevard
Brentwood,, Tennessee 37027
Title: Assistant Treasurer
Phone # (615) 296-3384

Banks or Depositories

Bank of America N.A.
600 Peachtree Street NE
14th Floor
Atlanta,, Georgia 30308

Signed: Mrs. Ashley M. Crabtree
Date Signed: 03/20/2019

(End FEC FORM 1)

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