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FEC Disclosure Form 1M for Society of Interventional Pain Management Surgery Centers PACForm 1M for Society of Interventional Pain Management Surgery Centers PAC

FEC FORM 1M

NOTIFICATION OF MULTICANDIDATE STATUS

FILING FEC-236347


1. Society of Interventional Pain Management Surgery Centers PAC

2831 Lone Oak Road
Paducah, KY 42003

2. FEC Committee ID #: C00416628

3. This is NOT a state party committee

4. STATUS BY AFFILIATION:

The committee submitted its Statement of Organization (FEC FORM 1)
on 11/02/2005 and simultaneously qualified as a multicandidate committee through its
affiliation with:

Committee Name: American Society of Interventional Pain Physicians PAC
FEC Identification Number: C00351197

5. STATUS BY QUALIFICATION:

(a) Candidates: The committee has made contributions to the five federal candidates listed below:


NameOffice SoughtState/DistrictDate
(i)

____/
(ii)

____/
(iii)

____/
(iv)

____/
(v)

____/

(b) Contributors: The committee received a contribution from its 51st contributor on: __________________.

(c) Registration: The committee has been registered for at least 6 months. FEC FORM 1 was submitted on: __________________.

(d) Qualification: The committee met the above requirements on:

Treasurer: Laxmaiah Manchikanti, MD
Date Signed: 08/31/2006

(End FEC FORM 1M)


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