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FEC Form 1 for Physician Hospitals of America Political Action CommitteeForm 1 for Physician Hospitals of America Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-728779


1. Physician Hospitals of America Political Action Committee

    PO Box 70980
    Washington, DC 20024

    NOTE: Address is different than previously reported

    Email: info@physicianhospitals.org

    NOTE: Email address is different than previously reported

2. Date: 05/18/2011

3. FEC Committee ID #: C00394163 This committee is a separate segregated fund. Its connected organization is a Trade Association
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Physician Hospitals of America
2025 M Street NW
Suite 800
Washington, DC 20036
Affiliated Relationship Code: Connected Organization

Custodian of Records:

John Richardson
PO Box 70980
Washington, DC 20024
Title: Treasurer
Phone # (202) 367-1113

Treasurer:

John Richardson
PO Box 70980
Washington, DC 20024
Title: Treasurer
Phone # (202) 367-1113

Designated Agent(s):

Banks or Depositories

Wells Fargo Bank
PO Box 5128
Sioux Falls, South Dakota 57117

Signed: John Richardson
Date Signed: 05/18/2011

(End FEC FORM 1)


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