FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-1388823
1. MAXIM HEALTHCARE SERVICES INC POLITICAL ACTION COMMITTEE (MAXIM HEALTHCARE PAC)
7227 Lee Deforest DriveColumbia, MD 21046
Email: kfernand@maxhealth.com;maxim@venable.com
NOTE: Email address is different than previously reported
2. Date: 03/10/2020
3. FEC Committee ID #: C00558932 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
Maxim Healthcare Services, Inc.7227 Lee Deforest Drive
Columbia, Maryland 21046
Affiliated Relationship Code: Connected Organization
Custodian of Records:
Kirstyn Estes7227 Lee Deforest Drive
Columbia, MD 21046
Title: Treasurer
Phone # (410) 910-1500
Treasurer:
Kirstyn Estes7227 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