FEC Form 1 for National Community Pharmacists Association - PACForm 1 for National Community Pharmacists Association - PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-872447

1. National Community Pharmacists Association - PAC

100 Daingerfield Road
Alexandria, VA 223142885
Email: karry.laviolette@ncpanet.org

2. Date: 05/23/2013

3. FEC Committee ID #: C00030809 This committee is a separate segregated fund. Its connected organization is a Membership Organization
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

National Community Pharmacists Association
100 Daingerfield Road
Alexandria, Virginia 223142885
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Karry LaViolette
100 Daingerfield Road
Alexandria, VA 22314
Title: Custodian of Records
Phone # (703) 600-1180

Treasurer:

Ms. Karry LaViolette
100 Daingerfield Road
Alexandria, Virginia 22314
Title: Treasurer
Phone # (703) 600-1180

Designated Agent(s):

Banks or Depositories

SUNTRUSTBANK
PO Box 179
Alexandria, Virginia 22314

Virginia Commerce Bank
1414 Prince Street
Alexandria, Virginia 22314

Signed: Ms. Karry LaViolette
Date Signed: 05/23/2013

(End FEC FORM 1)

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