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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-331964

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1. Orthopedic Hospital of Oklahoma, LLC Federal PAC

    2408 East 81st Street
    Tulsa, OK 74137
    Fax: 9184775995
    Email: rferguson@orthooklahoma.com

2. Date: 04/11/2008

3. FEC Committee ID #: C00393975 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Richard H. Ferguson
2408 E 81st St. Ste, 300
Tulsa, OK 74137
Title: Treasurer
Phone # (918) 477-5048

Treasurer:

Richard H. Ferguson
2408 E 81st St. Ste, 300
Tulsa, Oklahoma 74137
Title: Treasurer
Phone # (918) 477-5048

Designated Agent(s):

Banks or Depositories

United Missouri Bank
1437 S. Boulder
Tulsa, Oklahoma 74119

Signed: Richard H. Ferguson
Date Signed: 04/11/2008
Official Committee URL: www.orthooklahoma.com
Official Committee FAX: 9184775995

(End FEC FORM 1)

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