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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1538736

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1. TRI WEST HEALTHCARE ALLIANCE CORP. PAC (TRIWEST ALLIANCE PAC)

    15810 N. 28th AVE
    PHOENIX, AZ 85053
    Email: mabrill@comerica.com,zspacs@gmail.com

    NOTE: Email address is different than previously reported

2. Date: 09/16/2021

3. FEC Committee ID #: C00459743 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

TRIWEST HEALTHCARE ALLIANCE CORP.
15810 N. 28th AVE
PHOENIX, Arizona 85053
Affiliated Relationship Code: Connected Organization

Custodian of Records:

COMERICA BANK PAC SERVICES
PO Box 75000
MC 7544
DETROIT, MI 482757544
Title: BOOK KEEPER
Phone # (734) 632-5912

Treasurer:

ELIZABETH KINSLEY
15810 N. 28th AVE
PHOENIX, Arizona 85053
Title: Treasurer
Phone # (602) 564-2120

Designated Agent(s):

Banks or Depositories

COMERICA BANK
P.O. BOX 75000
DETROIT, Michigan 48275

Signed: ELIZABETH KINSLEY
Date Signed: 09/16/2021

FORM TEXT-1

(End FEC FORM 1)

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