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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1274838

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1. Urgent Care Association Political Action Committee

    28600 Bella Vista Parkway
    Suite 2010
    Warrenville, IL 60555
    Email: sginter@carewelluc.com;kyoungblood@ucaoa.org

2. Date: 10/12/2018

3. FEC Committee ID #: C00689844 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Urgent Care Association
28600 Bella Vista Parkway
Warrenville, Illinois 60555
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Shaun Gitner
2 Adams Place
Suite 305
Quincy, MA 02169
Title: Treasurer
Phone # (617) 302-4194

Treasurer:

Shaun Gitner
2 Adams Place
Suite 305
Quincy, Massachusetts 02169
Title: Treasurer
Phone # (617) 302-4194

Designated Agent(s):

Kim Youngblood
28600 Bella Vista Parkway
Suite 2010
Warrenville, Illinois 60555
Title: Assistant Treasurer
Phone # (630) 544-6534

Banks or Depositories

Hinsdale Bank & Trust
25 East First Street
Hinsdale, Illinois 60521

Signed: Shaun Gitner
Date Signed: 10/18/2018

(End FEC FORM 1)

Generated Wed Jul 24 06:31:22 2024