FEC Form 1 for American Dental Association Independent Expenditures CommitteeForm 1 for American Dental Association Independent Expenditures Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-746072

1. American Dental Association Independent Expenditures Committee

NOTE:Commmittee Name is different than previously reported

1111 14th Street, NW
Suite 1100
Washington, DC 20005
Email: taylorc@ada.org

2. Date: 09/22/2011

3. FEC Committee ID #: C00488338

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Custodian of Records:

CYNTHIA TAYLOR
1111 14TH STREET, NW, SUITE 1100
WASHINGTON, DC 20005
Title: MANAGER, MEMBERSHIP
Phone # (202) 789-5172

Treasurer:

Dr. Francis Connor
1111 14th Street, NW
Suite 1100
Washington, DC 20005
Title: dentist
Phone # (202) 789-5172

Designated Agent(s):

Banks or Depositories

CITIBANK
1101 PENNSYLVANIA AVENUE, NW
WASHINGTON, DC 20004

Signed: Dr. Francis Connor
Date Signed: 09/22/2011

FORM TEXT

(End FEC FORM 1)

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