FEC Form 1 for EMBLEMHEALTH SERVICES COMPANY LLC FEDERAL PAC (AKA EMBLEMHEALTH PAC)Form 1 for EMBLEMHEALTH SERVICES COMPANY LLC FEDERAL PAC (AKA EMBLEMHEALTH PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1148171

1. EMBLEMHEALTH SERVICES COMPANY LLC FEDERAL PAC (AKA EMBLEMHEALTH PAC)

55 WATER STREET
NEW YORK, NY 10041
Email: RFox@emblemhealth.com

2. Date: 02/08/2017

3. FEC Committee ID #: C00412247 This committee is a Principal Campaign Committee. Candidate:
Party:
Office Sought:
State is in District:

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Treasurer:

Mr. Robert Fox, Esq.
55 water Street
New York, New York 100418190
Title: General Counsel
Phone # (646) 447-6180

Designated Agent(s):

Mr. Robert Fox, Esq.
55 water Street
New York, New York 100418190

Banks or Depositories

TD Bank
2 Wall Street
New York, New York 10005

Signed: Mr. Robert Fox, Esq.
Date Signed: 02/08/2017

(End FEC FORM 1)

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