FEC Form 1 for American Society for Metabolic and Bariatric Surgery Political Action Committee, Inc.Form 1 for American Society for Metabolic and Bariatric Surgery Political Action Committee, Inc.

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1026914

1. American Society for Metabolic and Bariatric Surgery Political Action Committee, Inc.

NOTE:Commmittee Name is different than previously reported

100 SW 75th Street
Suite 201
Gainesville, FL 32607
Email: mallorygn@asmbs.org;jennifer@asmbs.org

2. Date: 10/06/2015

3. FEC Committee ID #: C00587923 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

American Society for Metabolic and Bariatric Surgery, Inc.
100 SW 75th Street
Suite 201
Gainesville, Florida 32607
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Georgeann Mallory
100 SW 75th Street
Suite 201
Gainesville, FL 32607
Title: Secretary
Phone # (352) 331-4900

Treasurer:

Jennifer Wynn
100 SW 75th Street
Suite 201
Gainesville, Florida 32607
Title: Treasurer
Phone # (352) 331-4900

Designated Agent(s):

Mark S Thomas
5200 SW 91st Terrace
Suite 101-B
Gainesville, Florida 32608
Title: Legal Counsel
Phone # (352) 372-9990

Banks or Depositories

Bank of America
2627 NW 43rd Street
Gainesville, Florida 32606

Signed: Jennifer Wynn
Date Signed: 10/06/2015
Official Committee URL: http://asmbs.org

(End FEC FORM 1)

Generated Fri Jul 26 08:39:35 2024