FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-1158696
1. TIVITY HEALTH FEDERAL PAC
NOTE:Commmittee Name is different than previously reported
701 COOL SPRINGS BLVD.FRANKLIN, TN 37067
Email: Vicki.shepard@tivityhealth.com
NOTE: Email address is different than previously reported
2. Date: 04/17/2017
3. FEC Committee ID #: C00411918 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
Tivity Health701 Cool Springs Blvd
.
Franklin, Tennessee 37067
Affiliated Relationship Code: Connected Organization
Custodian of Records:
Derek Ferris701 Cool Springs Blvd
Franklin, TN 37067
Title: Spec Assoc Purch
Phone # (615) 614-4249
Treasurer:
Glenn Hargreaves701 Cool Springs Blvd.
Franklin, Tennessee 37067
Title: CAO and Interim CFO
Phone # (615) 614-4388
Designated Agent(s):
Derek Ferris701 Cool Springs Blvd
Franklin, Tennessee 37067
Banks or Depositories
SunTrust BankPO Box 622227
Orlando, Florida 32862