FEC Form 1 for American Academy of Family Physicians Political Action CommitteeForm 1 for American Academy of Family Physicians Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-809542

1. American Academy of Family Physicians Political Action Committee

1133 Connecticut Ave NW
Suite 1100
Washington, DC 20036

NOTE: Address is different than previously reported

Email: fammedpac@aafp.org

2. Date: 10/02/2012

3. FEC Committee ID #: C00411553 This committee is a separate segregated fund. Its connected organization is a Membership Organization
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

American Academy of Family Physicians
11400 Tomahawk Creek Parkway
Leawood, Kansas 66211
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mark V Cribben
2021 Massachusetts Ave., NW
Washington, DC 20036
Title: Assistant Treasurer
Phone # (202) 232-9033

Treasurer:

Dr. Randell K Wexler
2021 Massachusetts Ave., NW
Washington, DC 20036
Title: Treasurer
Phone # (202) 232-9033

Designated Agent(s):

Mark V Cribben
2021 Massachusetts Ave., NW
Washington, DC 20036
Title: Director
Phone # (202) 232-9033

Banks or Depositories

Bank of America
P.O. Box 25118
Tampa, Florida 33622

Signed: Dr. Randell K. Wexler, MD
Date Signed: 09/14/2012
Official Committee URL: http://www.fammedpac.org

(End FEC FORM 1)

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