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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-747897

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1. MOBILE MEDICAL INTERNATIONAL CORPORATION PAC

    2176 PORTLAND STREET
    PO BOX 672
    ST JOHNSBURY, VT 05819
    Email: lsilvestre@mmicglobal.com

    NOTE: Email address is different than previously reported

2. Date: 10/13/2011

3. FEC Committee ID #: C00448761 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

Mobile Medical International Corporation
2176 Portland Street
PO Box 672
St. Johnsbury, Vermont 05819
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Rick Cochran
2176 PORTLAND STREET
PO BOX 672
ST JOHNSBURY, VT 05819
Title: Treasurer
Phone # (802) 748-2322

Treasurer:

Rick Cochran
2176 PORTLAND STREET
PO BOX 672
ST JOHNSBURY, Vermont 05819
Title: Treasurer
Phone # (802) 748-2322

Designated Agent(s):

Diane Evans
1831 Bay Street, SE
Washington, DC 20003
Title: Assistant Treasurer
Phone # (202) 548-0880

Banks or Depositories

TD Banknorth
111 Main Street
Burlington, Vermont 05401

Signed: Rick Cochran
Date Signed: 10/13/2011

(End FEC FORM 1)

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