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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1217795

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1. Aetna Inc. Political Action Committee

    20 F Street, N.W.
    Suite 350
    Washington, DC 20001
    Email: paynel@aetna.com

    NOTE: Email address is different than previously reported

2. Date: 04/09/2018

3. FEC Committee ID #: C00181826 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

Aetna Inc.
151 Farmington Avenue
Hartford, Connecticut 06156
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Leslie B. Payne
20 F Street, NW
Suite 350
Washington, DC 20001
Title: Custodian of Records
Phone # (202) 559-8237

Treasurer:

Glen Chambers
20 F Street, NW
Suite 350
Washington, DC 20001
Title: Treasurer
Phone # (202) 419-7044

Designated Agent(s):

Leslie B. Payne
20 F Street, NW
Suite 350
Washington, DC 20001
Title: Assistant Treasurer
Phone # (202) 559-8237

Banks or Depositories

Bank of America
2775 Main Street
Hartford, Connecticut 06120

Signed: Glen Chambers
Date Signed: 04/09/2018

(End FEC FORM 1)

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