FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-911669
1. CAPELLA HEALTHCARE, INC. GOVERNMENT AFFAIRS COMMITTEE
501 CORPORATE CENTRE DRIVE STE 200FRANKLIN, TN 37067
Email: jim.wiseman@capellahealth.com
NOTE: Email address is different than previously reported
2. Date: 07/25/2011
3. FEC Committee ID #: C00421420 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
Capella Healthcare, Inc.501 Corporate Centre Drive
Suite 200
Franklin, Tennessee 37067
Affiliated Relationship Code: Connected Organization
Custodian of Records:
James R. Wiseman501 Corporate Centre Drive
Suite 200
Franklin, TN 37067
Title: Treasurer
Phone # (615) 764-3007
Treasurer:
James R. Wiseman501 Corporate Centre Drive
Suite 200
Franklin, Tennessee 37067
Title: Treasurer
Phone # (615) 764-3042
Designated Agent(s):
Neil Kunkel501 Corporate Centre Drive
Suite 200
Franklin, Tennessee 37067
Title: SVP/Chief Counsel
Phone # (615) 764-3000
Banks or Depositories
Suntrust Bank731 Cool Springs Blvd
Franklin, Tennessee 37067