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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1704802

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1. WASHINGTON DENTAL SERVICE POLITICAL ACTION COMMITTEE

    400 FAIRVIEW AVE. N
    SUITE 800
    SEATTLE, WA 98109
    Email: JHU@DELTADENTALWA.COM;SPICKARD@DELTADENTALWA.COM

    NOTE: Email address is different than previously reported

2. Date: 05/18/2023

3. FEC Committee ID #: C00532440

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Jessica Hubly
400 Fairview Ave. N
Suite 800
Seattle, WA 98040
Title: Dir. of Finance
Phone # (206) 528-5321

Treasurer:

Sean P Pickard
400 Fairview Ave. N
Suite 800
Seattle, Washington 98109
Title: Dir. Gov. Relations
Phone # (206) 528-2304

Designated Agent(s):

Bradley A Berg
400 Fairview Ave. N
Suite 800
Seattle, Washington 98109
Title: CAO
Phone # (206) 528-2340

Banks or Depositories

Bank of America
275 Valencia Ave.
Brea, California 92823

Signed: Sean P Pickard
Date Signed: 05/18/2023

(End FEC FORM 1)

Generated Sun Sep 29 08:58:28 2024