FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-1249101
1. CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY/ATRIUM HEALTH EMPLOYEES FED PAC
NOTE:Commmittee Name is different than previously reported
ATTENTION: MARY ANN ROUSE1000 BLYTHE BOULEVARD
CHARLOTTE, NC 282032861
Email: MaryAnn.Rouse@CarolinasHealthCare.org
2. Date: 06/02/2006
3. FEC Committee ID #: C00423871 This committee is a separate segregated fund. Its connected organization is a Corporation W/O Capital StockAffiliated Committees/Organizations
Charlotte-Mecklenburg Hospital Authority D/B/A Atrium HealthAttention: Mary Ann Rouse
PO Box 32861
Charlotte, North Carolina 282322861
Affiliated Relationship Code: Connected Organization
Atrium Health Employees NC PAC
Attention: Mary Ann Rouse
PO Box 32861
Charlotte, North Carolina 282322861
Affiliated Relationship Code: Connected Organization
Custodian of Records:
Mary Ann RousePO Box 32861
Charlotte, NC 28232
Title: Treasurer
Phone # (704) 446-6129
Treasurer:
Mary Ann RousePO Box 32861
Charlotte, North Carolina 28232
Title: Treasurer
Phone # (704) 446-6129
Designated Agent(s):
Martha Ann Brawley McConnellPO Box 32861
Charlotte, North Carolina 28232
Title: Assistant Treasurer
Phone # (704) 446-3032
Banks or Depositories
Wells Fargo Bank, N.A.PO Box 63020
San Francisco, California 94163