FEC Form 1 for HMS Holdings Corp. Political Action Committee (HMS PAC)Form 1 for HMS Holdings Corp. Political Action Committee (HMS PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1045638

1. HMS Holdings Corp. Political Action Committee (HMS PAC)

360 Park Avenue South
17th Floor
New York, NY 10010
Email: hmspac@hms.com

2. Date: 01/29/2016

3. FEC Committee ID #: C00440453 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

HMS Holdings Corp.
360 Park Avenue South, 17th Floor
New York, New York 10010
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Greg Aunan
5615 High Point Drive
Irving, TX 75038
Title: Custodian
Phone # (212) 857-5940

Treasurer:

Greg Aunan
5615 High Point Drive
Irving, Texas 75038
Title: Treasurer
Phone # (212) 857-5940

Designated Agent(s):

Kristen Ballantine
1101 14th Street, N.W.
Suite 810
Washington, DC 20005
Title: Assistant Treasurer
Phone # (202) 448-2024

Banks or Depositories

JP Morgan Chase Bank, NA
1166 Avenue of the Americas
21 Fl
New York, New York 10038

Signed: Greg Aunan
Date Signed: 01/29/2016

(End FEC FORM 1)

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