FEC Disclosure Form 1M for Merit Medical Systems Inc Employee Good Governance PACForm 1M for Merit Medical Systems Inc Employee Good Governance PAC

FEC FORM 1M

NOTIFICATION OF MULTICANDIDATE STATUS

FILING FEC-789515

1. Merit Medical Systems Inc Employee Good Governance PAC

1600 Merit Parkway
South Jordan, UT 84095

2. FEC Committee ID #: C00475343

3. This is NOT a state party committee

4. STATUS BY AFFILIATION:

The committee submitted its Statement of Organization (FEC FORM 1)
on 04/16/2010 and simultaneously qualified as a multicandidate committee through its
affiliation with:

Committee Name: Merit Medical Systems, Inc. Employee Good Governance PAC
FEC Identification Number: C00475343

5. STATUS BY QUALIFICATION:

(a) Candidates: The committee has made contributions to the five federal candidates listed below:

	Name	Office Sought	State/District	Date
(i)	Mr. Rob Bishop	House of Representatives	Utah/01	08/28/2010
(ii)	Mr. Orrin Hatch	Senate	Utah/00	08/28/2010
(iii)	Mr. Michael Lee	Senate	Utah/00	08/28/2010
(iv)	Mr. Jason Chaffetz	House of Representatives	Utah/03	02/28/2011
(v)	Mr. Eric Cantor	House of Representatives	Virginia/07	11/28/2011

(b) Contributors: The committee received a contribution from its 51st contributor on: 03/24/2011

(c) Registration: The committee has been registered for at least 6 months. FEC FORM 1 was submitted on: 01/29/2010

(d) Qualification: The committee met the above requirements on: 11/28/2011

Treasurer: Mr Greg Fredde
Date Signed: 03/07/2012

(End FEC FORM 1M)

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