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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-973933

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1. Health Diagnostic Laboratory Inc. PAC

    737 N. 5th Street Suite 200
    Richmond, VA 23219
    Email: HDLPAC@hdlabinc.com

2. Date: 11/24/2014

3. FEC Committee ID #: C00526491 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Health Diagnostic Laboratory Inc.
737 N. 5th Street Suite 200
Richmond, Virginia 23219
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Michelle Kuhn
737 N. 5th Street Suite 103
Richmond, VA 23219
Title: Custodian of Records
Phone # (804) 343-2718

Treasurer:

Michelle Kuhn
737 N. 5th Street Suite 103
Richmond, Virginia 23219
Title: Treasurer
Phone # (804) 343-2718

Designated Agent(s):

Banks or Depositories

Burke & Herbert Bank
302 Maple Avenue West
Vienna, Virginia 22180

Signed: Michelle Kuhn
Date Signed: 11/24/2014

FORM TEXT

(End FEC FORM 1)

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