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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1525277

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1. CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY/ATRIUM HEALTH EMPLOYEES FED PAC

    NOTE:Commmittee Name is different than previously reported

    ATTENTION: DAVID S. THOMAS
    1000 BLYTHE BOULEVARD
    CHARLOTTE, NC 282032861
    Email: MarthaAnn.McConnell@AtriumHealth.org

    NOTE: Email address is different than previously reported

2. Date: 07/14/2021

3. FEC Committee ID #: C00423871 This committee is a separate segregated fund. Its connected organization is a Corporation W/O Capital Stock

Affiliated Committees/Organizations

Charlotte-Mecklenburg Hospital Authority D/B/A Atrium Health
Attention: David S. Thomas
PO Box 32861
Charlotte, North Carolina 282322861
Affiliated Relationship Code: Connected Organization

Atrium Health Employees NC PAC
Attention: David S. Thomas
PO Box 32861
Charlotte, North Carolina 282322861
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Martha Ann McConnell
PO Box 32861
Charlotte, NC 28232
Title: Assistant Treasurer
Phone # (704) 614-1538

Treasurer:

Martha Ann McConnell
PO Box 32861
Charlotte, North Carolina 28232
Title: Assistant Treasurer
Phone # (704) 614-1538

Designated Agent(s):

Martha Ann Brawley McConnell
PO 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

Signed: Martha Ann McConnell
Date Signed: 07/14/2021

(End FEC FORM 1)

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