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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-704763

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1. ProCure Treatment Centers Inc. PAC

    192 Lexington Avenue 4th Floor
    New York, NY 10016
    Email: procurepac@gmail.com

2. Date: 01/10/2011

3. FEC Committee ID #: C00476812 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

ProCure Treatment Centers, Inc.
192 Lexington Ave., 4th Floor
New York, New York 10016
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Ann-Marie Koss
192 Lexington Ave., 4th Floor
New York, NY 10016
Title: Custodian
Phone # (212) 584-0944

Treasurer:

Vincent Tallman
1950 Roland Clarke Place, Ste 300
Reston, Virginia 20191
Title: Treasurer
Phone # (703) 476-3070

Designated Agent(s):

Marcia Sajewicz
192 Lexington Ave., 4th Floor
New York, New York 10016
Title: Assistant Treasurer
Phone # (212) 584-0951

Ann-Marie Koss
192 Lexington Ave.
4th Floor
New York, New York 10016
Title: Assistant Treasurer
Phone # (212) 584-0944

Banks or Depositories

Bank of America, N.A.
P.O. Box 25118
Tampa, Florida 33622

Signed: Vincent Tallman
Date Signed: 01/10/2011

FORM TEXT

(End FEC FORM 1)

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