FEC Form 1 for Alliance for Quality Nursing Home Care Inc. Politlcal Action Committee (AQNHC PAC)Form 1 for Alliance for Quality Nursing Home Care Inc. Politlcal Action Committee (AQNHC PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-728845

1. Alliance for Quality Nursing Home Care Inc. Politlcal Action Committee (AQNHC PAC)

1350 Connecticut Avenue NW
Suite 900
Washington, DC 20036
Email: compliance@aqnhc.org

2. Date: 05/16/2011

3. FEC Committee ID #: C00432336 This committee is a separate segregated fund. Its connected organization is a Trade Association
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Alliance for Quality Nursing Home Care Inc.
1350 Connecticut Avenue NW
Suite 900
Washington, DC 20036
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Alan Rosenbloom
1350 Connecticut Avenue NW
Suite 900
Washington, DC 20036
Title: Treasurer
Phone # (202) 459-6310

Treasurer:

Alan Rosenbloom
1350 Connecticut Avenue NW
Suite 900
Washington, DC 20036
Title: Treasurer
Phone # (202) 459-6310

Designated Agent(s):

Banks or Depositories

PNC Bank, NA
810 Estelle Drive
Lancaster, Pennsylvania 17601

SunTrust Bank
25 Park Place
Atlanta, Georgia 30303

Signed: Alan Rosenbloom
Date Signed: 05/16/2011

(End FEC FORM 1)

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