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FEC Disclosure Form 1M for AmSurg Corp. Good Government FundForm 1M for AmSurg Corp. Good Government Fund

FEC FORM 1M

NOTIFICATION OF MULTICANDIDATE STATUS

FILING FEC-745980


1. AmSurg Corp. Good Government Fund

20 Burton Hills Blvd.
Suite 500
d, TN 37215

2. FEC Committee ID #: C00484410

3. This is NOT a state party committee

4. STATUS BY AFFILIATION:

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

Committee Name: ________________________
FEC Identification Number: _______________________

5. STATUS BY QUALIFICATION:

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


NameOffice SoughtState/DistrictDate
(i) Bill Cassidy
House of Representatives
Louisiana/06
03/04/2011
(ii) Thomas E. Price
House of Representatives
Georgia/06
03/04/2011
(iii) John B. Larson
House of Representatives
Connecticut/01
04/06/2011
(iv) Marsha Blackburn
House of Representatives
Tennessee/07
05/09/2011
(v) Ben Cardin
Senate
Maryland/
06/24/2011

(b) Contributors: The committee received a contribution from its 51st contributor on: 06/30/2011

(c) Registration: The committee has been registered for at least 6 months. FEC FORM 1 was submitted on: 06/04/2010

(d) Qualification: The committee met the above requirements on: 06/30/2011

Treasurer: Thomas M. Sloan, Jr.
Date Signed: 09/21/2011

(End FEC FORM 1M)


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