FEC Form 1 for Gentiva Health Services Inc PAC GentivaPACForm 1 for Gentiva Health Services Inc PAC GentivaPAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1616570

1. Gentiva Health Services Inc PAC GentivaPAC

3350 Riverwood Parkway, Suite 1400
Atlanta, GA 30339
Email: GentivaPAC@myfecnotices.com

2. Date: 07/15/2022

3. FEC Committee ID #: C00407080 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Gentiva Health Services Inc
3350 Riverwood Parkway, Suite 1400
Atlanta, Georgia 30339
Affiliated Relationship Code: Connected Organization

Committee ID# C00271007
HUMANA INC. POLITICAL ACTION COMMITTEE
975 F STREET, NW
SUITE 520
WASHINGTON, DC 20004
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Ronald Lazas, Jr.
3350 Riverwood Pkwy, Suite 1400
Atlanta, GA 30339
Title: PAC Treasurer
Phone # (770) 951-6426

Treasurer:

Ronald Lazas, Jr.
3350 Riverwood Pkwy, Suite 1400
Atlanta, Georgia 30339
Title: PAC Treasurer
Phone # (770) 951-6426

Designated Agent(s):

Banks or Depositories

Bank of America
PO Box 31900
Tampa, Florida 336313900

Signed: Ronald Lazas, Jr.
Date Signed: 07/18/2022

(End FEC FORM 1)

Generated Mon Dec 23 07:14:39 2024