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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-746064

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1. ALMOST FAMILY INC PAC (AFAM PAC)

    9510 ORMSBY STATION ROAD SUITE 300
    LOUISVILLE, KY 40223
    Email: ToddLyles@almostfamily.com

    NOTE: Email address is different than previously reported

2. Date: 09/15/2011

3. FEC Committee ID #: C00460253 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Almost Family, Inc.
9510 Ormsby Station Road
Suite 300
Louisville, Kentucky 40223
Affiliated Relationship Code: Connected Organization

Custodian of Records:

C. Steven Guenthner
9510 Ormsby Station Road
Suite 300
Louisville, KY 40223
Title: Custodian of Records
Phone # (502) 891-1000

Treasurer:

C. Steven Guenthner
9510 Ormsby Station Road
Suite 300
Louisville, Kentucky 40223
Title: Treasurer
Phone # (502) 891-1000

Designated Agent(s):

Patrick T. Lyles
9510 Ormsby Station Road
Suite 300
Louisville, Kentucky 40223
Title: Assistant Treasurer
Phone # (502) 891-1000

Banks or Depositories

J.P. Morgan Chase
416 West Jefferson Street, 2nd Fl.
P.O. Box 32500
Louisville, Kentucky 40232

Signed: C. Steven Guenthner
Date Signed: 09/22/2011

(End FEC FORM 1)

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