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-495093

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

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

NOTE: Email address is different than previously reported

2. Date: 09/24/2010

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:

Ronald Engelbreit
5550 Meadowbrook
Rolling Meadows, IL 60008
Title: Assistant Treasurer
Phone # (847) 378-0509

Treasurer:

Dr. Robert E. Harbaugh
30 Hope Dr. EC110
Hershey, Pennsylvania 17033
Title: Treasurer
Phone # (717) 531-4383

Designated Agent(s):

Ronald Engelbreit
5550 Meadowbrook
Rolling Meadows, Illinois 60008
Title: Assistant Treasurer
Phone # (847) 378-0509

Banks or Depositories

Chase
120 S. LaSalle St.
Chicago, Illinois 60603

Signed: Dr. Robert E. Harbaugh
Date Signed: 09/24/2010
Official Committee URL: http://www.aans.org/Legislative%20Activities/NeurosurgeryPAC.aspx

NOTE: URL is different than previously reported

(End FEC FORM 1)

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