FEC Form 1 for CAROLINA NEUROSURGERY AND SPINE ASSOCIATES P A PACForm 1 for CAROLINA NEUROSURGERY AND SPINE ASSOCIATES P A PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1273574

1. CAROLINA NEUROSURGERY AND SPINE ASSOCIATES P A PAC

225 BALDWIN AVENUE
CHARLOTTE, NC 28204
Email: mary.cloninger@cnsa.com;mary.cloninger@cnsa.com

NOTE: Email address is different than previously reported

2. Date: 10/16/2018

3. FEC Committee ID #: C00544841 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Committee ID# C00544841
CAROLINA NEUROSURGERY AND SPINE ASSOCIATES P A PAC
225 BALDWIN AVENUE
CHARLOTTE, North Carolina 28204
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Dr Craig VanDerVeer
225 Baldwin Ave
Charlotte, NC 28204
Title: Custodian
Phone # (704) 831-3100

Treasurer:

Dr Craig VanDerVeer
225 Baldwin Ave
Charlotte, North Carolina 28204
Title: Treasurer
Phone # (704) 831-3100

Designated Agent(s):

Mary Cloninger
225 Baldwin Avenue
Charlotte, North Carolina 28204
Title: Assistant Treasurer
Phone # (704) 831-3100

Banks or Depositories

SunTrust Bank
PO Box 305183
Nashville, Tennessee 372305183

Signed: Dr Craig VanDerVeer
Date Signed: 10/16/2018
Official Committee URL: cnsa.com

(End FEC FORM 1)

Generated Sat Aug 17 15:58:58 2024