FEC Form 1 for Partnership for Medicaid Home-Based Care PACForm 1 for Partnership for Medicaid Home-Based Care PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1158943

1. Partnership for Medicaid Home-Based Care PAC

300 New Jersey Avenue, NW
Suite 900
Washington, DC 20001
Email: admin@asher-law.com

2. Date: 04/18/2017

3. FEC Committee ID #: C00637959 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Partnership for Medicaid Home-Based Care
300 New Jersey Avenue, NW
Suite 900
Washington, DC 20001
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Gale Bohling
300 New Jersey Avenue, NW
Suite 900
Washington, DC 20001
Title: Treasurer
Phone # (502) .39-4.21

Treasurer:

Gale Bohling
300 New Jersey Avenue, NW
Suite 900
Washington, DC 20001
Title: Treasurer
Phone # (502) .39-4.21

Designated Agent(s):

Banks or Depositories

PNC Bank
800 17th Street, NW
Washington, DC 20005

Signed: Gale Bohling
Date Signed: 04/19/2017

(End FEC FORM 1)

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