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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-161392

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1. Safeway Inc. Political Action Committee (SafePAC)

    5918 Stoneridge Mall Rd
    Pleasanton, CA 945883229

    NOTE: Address is different than previously reported

    Fax: 9254673323
    Email: dominick.ciaraldi@safeway.com

2. Date: 01/27/2005

3. FEC Committee ID #: C00194084 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Safeway Inc.
5918 Stoneridge Mall Rd
Pleasanton, California 945883229
Relationship: Connected
Organization Type: Corporation

Custodian of Records:

Dominick Ciaraldi
5918 Stoneridge Mall Rd
GW5353
Pleasanton, CA 945883229
Title: Custodian of Records
Phone # (925) 467-3102

Treasurer:

Dominick Ciaraldi
5918 Stoneridge Mall Rd
GW5353
Pleasanton, California 945883229
Title: Treasurer
Phone # (925) 467-3102

Designated Agent(s):

Kevin Herglotz
5918 Stoneridge Mall Rd
Pleasanton, California 945883229
Title: Assistant Treasurer
Phone # (925) 467-2957

Banks or Depositories

Bank of America
P.O. Box 27128
Concord, California 94520

Signed: Dominick Ciaraldi
Date Signed: 01/27/2005
Official Committee FAX: 9254673323

(End FEC FORM 1)

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