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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1737256

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1. KENTUCKY HOSPITAL ASSOCIATION POLITICAL ACTION COMMITTEE

    2501 NELSON MILLER PARKWAY
    LOUISVILLE, KY 40253
    Email: bwarman@kyha.com;bwates@kyha.com

    NOTE: Email address is different than previously reported

2. Date: 11/29/2023

3. FEC Committee ID #: C00806117 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Committee ID# C00106146
AMERICAN HOSPITAL ASSOCIATION PAC
800 TENTH STREET, NW
TWO CITYCENTER, SUITE 400
WASHINGTON, DC 20001
Affiliated Relationship Code: Affiliated Committee

Kentucky Hospital Association
2501 Nelson Miller Parkway
Louisville, Kentucky 40252
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Brent Wates
2501 Nelson Miller Parkway
Louisville, KY 40253
Title: Custodian of Records
Phone # (502) 992-4343

Treasurer:

Harold C Warman, Jr.
2501 NELSON MILLER PARKWAY
Louisville, Kentucky 40253
Title: Treasurer
Phone # (502) 992-4348

Designated Agent(s):

James Musser
2501 Nelson Miller Parkway
Louisville, Kentucky 40253
Title: Assistant Treasurer
Phone # (502) 593-2339

Banks or Depositories

Republic Bank & Trust
601 W. Market Street
Louisville, Kentucky 40202

Signed: Harold C Warman, Jr.
Date Signed: 11/29/2023

(End FEC FORM 1)

Generated Fri Nov 8 14:13:58 2024