FEC Form 1 for AMERICAN MEDICAL ASSOCIATION POLITICAL ACTION COMMITTEEForm 1 for AMERICAN MEDICAL ASSOCIATION POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-407638

1. AMERICAN MEDICAL ASSOCIATION POLITICAL ACTION COMMITTEE

25 MASSACHUSETTS AVENUE, NW
SUITE 600
WASHINGTON, DC 20001
Email: KEVIN.WALKER@AMA-ASSN.ORG

2. Date: 03/11/2009

3. FEC Committee ID #: C00000422 This committee is a separate segregated fund. Its connected organization is a
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

AMERICAN MEDICAL ASSOCIATION
515 NORTH STATE STREET
CHICAGO, Illinois 60654
Affiliated Relationship Code: Connected Organization

Committee ID# C00004911
ALABAMA MEDICAL PAC
PO BOX 1900
MONTGOMERY, Alabama 36102
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00003194
CALIFORNIA MEDICAL PAC
1201 J STREET
SAN FRANCISCO, California 95814
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00001685
GEORGIA MEDICAL PAC
1849 THE EXCHANGE
ATLANTA, Georgia 30339
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00001347
HAWAII MEDICAL PAC
1360 S BERETANIA STREET
HONOLULU, Hawaii 96814
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00000638
INDIANA MEDICAL PAC
322 CANAL WALK
INDIANAPOLIS, Indiana 46202
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00003327
OHIO MEDICAL PAC
3401 MILL RUN DRIVE
HILLIARD, Ohio 43206
Affiliated Relationship Code: Affiliated Committee

OKLAHOMA MEDICAL PAC
PO BOX 54520
OKLAHOMA CITY, Oklahoma 73154
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00035766
OREGON MEDICAL PAC
5210 SW CORBETT STREET
PORTLAND, Oregon 97201
Affiliated Relationship Code: Affiliated Committee

KANSAS MEDICAL PAC
623 SW 10TH
TOPEKA, Kansas 66612
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00016444
KENTUCKY EDUC MEDICAL PAC
4965 US HIGHWAY 42
LOUISVILLE, Kentucky 40222
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00001008
LOUISIANA MEDICAL PAC
6767 PERKINS ROAD
BATON ROUGE, Louisiana 70802
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00001180
MICHIGAN DOCTORS PAC
PO BOX 769
EAST LANSING, Michigan 48826
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00001420
MISSOURI MEDICAL PAC
PO BOX 1402
JEFFERSON CITY, Missouri 65102
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00002147
NEBRASKA MEDICAL PAC
233 S 13TH STREET
LINCOLN, Nebraska 68508
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00039123
NEW JERSEY MEDICAL PAC
2 PRINCESS ROAD
LAWRENCEVILLE, New Jersey 08648
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00004929
PENNSYLVANIA MEDICAL PAC
PO BOX 8820
HARRISBURG, Pennsylvania 17105
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00005132
SOUTH DAKOTA MEDICAL PAC
1323 S MINNESOTA AVENUE
SIOUX FALLS, South Dakota 57105
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00001214
TEXAS MEDICAL PAC
401 W 15TH STREET
AUSTIN, Texas 78701
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00003210
UTAH MEDICAL PAC
540 EAST FIFTH SOUTH
SALT LAKE CITY, Utah 84102
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00001818
WASHINGTON MEDICAL PAC
2033 SIXTH AVENUE
SEATTLE, Washington 98121
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00001461
ALASKA STATE MEDICAL ASSOCIATION POLIT
4107 Laurel Street
.
Anchorage, Alaska 99508
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00004499
ARIZONA MEDICAL ASSOCIATION INC POLICA
810 W. Bethany Home Road
Phoenix, Arizona 85013
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00005488
ILLINOIS STATE MEDICAL SOCIETY POLITIC
20 North Michigan Avenue
Suite 700
Chicago, Illinois 60602
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00003970
IOWA MEDICAL POLITICAL ACTION COMMITTE
1001 GRAND AVENUE
WEST DES MOINES, Iowa 50265
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00001776
NEW MEXICO MEDICAL SOCIETY POLITICAL A
7770 JEFFERSON NE #400
ALBUQUERQUE, New Mexico 87109
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00003152
NORTH CAROLINA MEDICAL SOCIETY FEDERAL
PO Box 25834
222 N. Person Street
Raleigh, North Carolina 27611
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

KEVIN WALKER
10635 CANTERBERRY ROAD
FAIRFAX STATION, VA 22039
Title: TREASURER
Phone # (202) 789-7467

Treasurer:

KEVIN WALKER
10635 CANTERBERRY ROAD
FAIRFAX STATION, Virginia 22039
Title: TREASURER
Phone # (202) 789-7467

Designated Agent(s):

MICHAEL CYS
7307 LAKETREE DRIVE
FAIRFAX STATION, Virginia 22039
Title: ASSISTANT TREASURER
Phone # (202) 789-7457

WILLIAM L HAMILTON, MD
8TH AVENUE AND C STREETS
SALT LAKE CITY, Utah 84143
Title: Secretary
Phone # (210) 614-3737

NICOLE LONETTO
4603 MANOR DRIVE
ALEXANDRIA, Virginia 22309
Title: ASSISTANT TREASURER
Phone # (202) 789-7433

Banks or Depositories

PNC ADVISORS
PO BOX 96211
WASHINGTON, DC 20090

PNC BANK
PO BOX 1912
WASHINGTON, DC 20074

Signed: KEVIN WALKER
Date Signed: 03/16/2009
Official Committee URL: AMPACONLINE.ORG

FORM TEXT

(End FEC FORM 1)

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