FEC Form 1 for UBS Americas Inc. Political Action Committee (UBS PAC)Form 1 for UBS Americas Inc. Political Action Committee (UBS PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-760424

1. UBS Americas Inc. Political Action Committee (UBS PAC)

NOTE:Commmittee Name is different than previously reported

400 ATLANTIC STREET
c/o Per Dyrvik
STAMFORD, CT 06901
Email: SH-PAC_Administrator@ubs.com

2. Date: 01/27/2012

3. FEC Committee ID #: C00012245 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

UBS Americas, Inc.
400 ATLANTIC STREET
STAMFORD, Connecticut 06901
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Sarah E. Donnelly
1501 K St NW
Suite 1100
Washington, DC 200051410
Title: PAC Administrator

Treasurer:

Per Dyrvik
400 Atlantic St
Stamford, Connecticut 069013512
Title: Treasurer
Phone # (203) 719-4381

Designated Agent(s):

Banks or Depositories

JPMorgan Chase Bank
1251 Avenue of the Americas
New York, New York 10020

Signed: Per Dyrvik
Date Signed: 01/27/2012

(End FEC FORM 1)

Generated Fri Jun 28 12:31:55 2024