FEC Form 1 for MAXIM HEALTHCARE SERVICES INC POLITICAL ACTION COMMITTEE (MAXIM HEALTHCARE PAC)Form 1 for MAXIM HEALTHCARE SERVICES INC POLITICAL ACTION COMMITTEE (MAXIM HEALTHCARE PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1175279

1. MAXIM HEALTHCARE SERVICES INC POLITICAL ACTION COMMITTEE (MAXIM HEALTHCARE PAC)

7227 Lee Deforest Drive
Columbia, MD 21046

NOTE: Address is different than previously reported

Email: chdefroz@maxhealth.com

NOTE: Email address is different than previously reported

2. Date: 07/26/2017

3. FEC Committee ID #: C00558932 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Maxim Healthcare Services, Inc.
7227 Lee Deforest Drive
Columbia, Maryland 21046
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Christopher DeFronzo
7227 Lee Deforest Drive
Columbia, Maryland 21046
Title: Treasurer
Phone # (410) 910-1500

Designated Agent(s):

Banks or Depositories

Bank of America, N.A.
790 Broad Street
Newark, New Jersey 07102

Signed: Christopher DeFronzo
Date Signed: 07/26/2017

(End FEC FORM 1)

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