FEC Disclosure Form 1M for American Kidney Stone Management, Ltd. Political Action Committee 'AKSM PAC'Form 1M for American Kidney Stone Management, Ltd. Political Action Committee 'AKSM PAC'

FEC FORM 1M

NOTIFICATION OF MULTICANDIDATE STATUS

FILING FEC-731584

1. American Kidney Stone Management, Ltd. Political Action Committee 'AKSM PAC'

100 West Third Ave Suite 350
Columbus, OH 43201

2. FEC Committee ID #: C00489419

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:

	Name	Office Sought	State/District	Date
(i)	JOHN TIMOTHY GRIFFIN	House of Representatives	Arkansas/02	10/14/2010
(ii)	JOSEPH R. PITTS	House of Representatives	Pennsylvania/16	03/22/2011
(iii)	STEVE MR. STIVERS	House of Representatives	Ohio/15	03/31/2011
(iv)	PATRICK J. TIBERI	House of Representatives	Ohio/12	10/22/2010
(v)	JOHN BOOZMAN	Senate	Arkansas/00	06/08/2011

(b) Contributors: The committee received a contribution from its 51st contributor on: 11/02/2010

(c) Registration: The committee has been registered for at least 6 months. FEC FORM 1 was submitted on: 09/24/2010

(d) Qualification: The committee met the above requirements on: 06/08/2011

Treasurer: Ric Hughes
Date Signed: 06/16/2011

(End FEC FORM 1M)

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