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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1059093

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1. CardioVascular Coalition, Inc. Political Action Committee

    610 S. Boulevard
    Tampa, FL 33606
    Email: nwatkins@robertwatkins.com

2. Date: 04/04/2016

3. FEC Committee ID #: C00591826 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

CardioVascular Coalition, Inc.
1425 K Street, N.W.
Suite 650
Washington, DC 20005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Nancy H. Watkins
610 S. Boulevard
Tampa, FL 33606
Title: Treasurer
Phone # (813) 254-3369

Treasurer:

Nancy H. Watkins
610 S. Boulevard
Tampa, Florida 33606
Title: Treasurer
Phone # (813) 254-3369

Designated Agent(s):

Robert I. Watkins
610 S. Boulevard
Tampa, Florida 33606
Title: Assistant Treasurer
Phone # (813) 254-3369

Banks or Depositories

The Bank of Tampa
P. O. Box One
Tampa, Florida 33601

Signed: Nancy H. Watkins
Date Signed: 04/07/2016

(End FEC FORM 1)

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