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-1472176

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

14260 W Newberry Road
#418
Newberry, FL 32669

NOTE: Address is different than previously reported

Email: outsourcing@aristotle.com;jennifer@asmbs.org

2. Date: 11/11/2020

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

Affiliated Committees/Organizations

American Society for Metabolic and Bariatric Surgery
14260 W Newberry Road
#418
Newberry, Florida 326692765
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Georgeann Mallory
100 SW 75th St
Ste 201
Gainesville, FL 326075776
Title: Custodian of Records
Phone # (352) 331-4900

Treasurer:

Jennifer Wynn
100 SW 75th St
Ste 201
Gainesville, Florida 326075776
Title: Treasurer
Phone # (352) 331-4900

Designated Agent(s):

Mark S Thomas
5200 SW 91st Ter
Ste 101B
Gainesville, Florida 326083021
Title: Designated Agent
Phone # (352) 372-9990

Banks or Depositories

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

Signed: Jennifer Wynn
Date Signed: 11/12/2020
Official Committee URL: http://asmbs.org/

FORM TEXT-1

(End FEC FORM 1)

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