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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-906778

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1. PACIFIC PULMONARY SERVICES POLITICAL ACTION COMMITTEE

    88 ROWLAND WAY SUITE 300
    NOVATO, CA 94945
    Email: nikkic@ppsc.com

2. Date: 02/04/2014

3. FEC Committee ID #: C00403998

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Nikki Chow
88 Rowland Way Suite 300
Novato, CA 94945
Title: VP of Finance
Phone # (415) 893-1518

Treasurer:

Nikki Chow
88 Rowland Way Suite 300
Novato, California 94945
Title: VP of Finance
Phone # (415) 893-1518

Designated Agent(s):

Karman Chan
88 Rowland Way
Novato, California 94945
Title: CFO
Phone # (415) 893-1518

Banks or Depositories

Bank of America
1655 Grant Street
Concord, California 94520

Signed: Nikki Chow
Date Signed: 02/04/2014

(End FEC FORM 1)

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