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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-900980

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1. Health Alliance Plan PAC

    2850 West Grand Boulevard
    Detroit, MI 48202
    Email: slruhl@comerica.com

    NOTE: Email address is different than previously reported

2. Date: 01/07/2014

3. FEC Committee ID #: C00410670 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Health Alliance Plan
2850 West Grand Boulevard
Detroit, Michigan 48202
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Comerica Bank PAC Services
MC 2250
PO Box 75000
Detroit, MI 48275
Title: Book Keeper
Phone # (248) 371-7271

Treasurer:

Rory Lafferty
2850 West Grand Boulevard
Detroit, Michigan 48202
Title: PAC Treasurer
Phone # (313) 664-8124

Designated Agent(s):

Banks or Depositories

Comerica Bank
PO Box 75000
Detroit, Michigan 48275

Signed: Rory Lafferty
Date Signed: 01/07/2014

FORM TEXT

(End FEC FORM 1)

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