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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-449261

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1. American College of Rheumatology (RheumPAC)

    2200 Lake Boulevard NE
    Atlanta, GA 30319

    NOTE: Address is different than previously reported

    Email: rheumpac@rheumatology.org

2. Date: 01/29/2010

3. FEC Committee ID #: C00432823 This committee is a separate segregated fund. Its connected organization is a Membership Organization
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

American College of Rheumatology
1800 Century Place, Suite 250
Atlanta, Georgia 30345
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Aiken Hackett
1800 Century Place, Suite 250
Atlanta, GA 30345
Title: Director, Govt Affai
Phone # (404) 633-3777

Treasurer:

Fred Dietz
2200 Lake Boulevard NE
Atlanta, Georgia 30319
Title: physician
Phone # (404) 633-3777

Designated Agent(s):

Tiffany Schmidt
2200 Lake Boulevard NE
Atlanta, Georgia 30319
Title: Vice President of So
Phone # (404) 633-3777

Banks or Depositories

SunTrust Bank
Mail Code 030
PO Box 4418
Atlanta, Georgia 30302

Signed: Fred Dietz
Date Signed: 01/29/2010

FORM TEXT

(End FEC FORM 1)

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