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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1104619

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1. Working Americans for Affordable Healthcare

    275 7th Ave
    16th Floor
    New York, NY 10001
    Email: ztkhan@unitehere.org

2. Date: 10/12/2016

3. FEC Committee ID #: C00627372

This committee is an independent expenditure-only political committee (Super PAC).

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Zaina Tannu-Khan
275 7th Avenue
16th Floor
New York, NY 10001
Title: Custodian
Phone # (212) 265-7000

Treasurer:

Timothy Barnes
275 7th Avenue
16th Floor
New York, New York 10001
Title: Treasurer
Phone # (202) 265-7000

Designated Agent(s):

Banks or Depositories

JPMorgan Chase
109 Delancy Street
New York, New York 10002

Signed: Timothy Barnes
Date Signed: 10/12/2016

FORM TEXT-1

(End FEC FORM 1)

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