FEC Form 1 for AMERICAN ASSOCIATION OF NEUROLOGICAL SURGEONS POLITICAL ACTION COMMITTEE (NEUROSURGERYPAC)Form 1 for AMERICAN ASSOCIATION OF NEUROLOGICAL SURGEONS POLITICAL ACTION COMMITTEE (NEUROSURGERYPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1081160

1. AMERICAN ASSOCIATION OF NEUROLOGICAL SURGEONS POLITICAL ACTION COMMITTEE (NEUROSURGERYPAC)

725 Fiftheenth St., NW Suite 500
Washington, DC 20005
Email: pbk@aans.org;sjk@aans.org

2. Date: 07/06/2016

3. FEC Committee ID #: C00413955 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Committee ID# C00413955
AMERICAN ASSOCIATION OF NEUROLOGICAL SURGEONS POLITICAL ACTION COMMITTEE (NEUROSURGERYPAC)
725 Fiftheenth St., NW Suite 500
Washington, DC 20005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

John A. Wilson
Medical Center Dr./Neurosurgery
Wake Forest University
Winston Salem, NC 27157
Title: Treasurer

Treasurer:

John A. Wilson
Medical Center Dr./Neurosurgery
Wake Forest University
Winston Salem, North Carolina 27157
Title: Treasurer
Phone # (847) 378-0501

Designated Agent(s):

Banks or Depositories

JP MORGAN CHASE
IL1-1228 10 South Dearborn Street
Chicago, Illinois 60603

Signed: John A. Wilson
Date Signed: 07/06/2016
Official Committee URL: http://www.aans.org/Legislative%20Activities/NeurosurgeryPAC.aspx

(End FEC FORM 1)

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