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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-898721

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1. Cracker Barrel Old Country Store, Inc. PAC

    307 Hartmann Drive
    PO Box 787
    Lebanon, TN 370880787
    Email: pat.sheehy@crackerbarrel.com,michael.zylstra@crackerbarrel.com

    NOTE: Email address is different than previously reported

2. Date: 12/31/2013

3. FEC Committee ID #: C00252791 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

Cracker Barrel Old Country Store, Inc.
Dept. 9425-4
PO Box 787
Lebanon, Tennessee 370880787
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Patrick Sheehy
307 Hartmann Drive
PO Box 787
Lebanon, TN 370880787
Title: Dir., Gov. Relations
Phone # (615) 235-4161

Treasurer:

Mr. Charlie Austin
305 Hartmann Drive
PO Box 787
Lebanon, Tennessee 370880787
Title: Regl. VP, Rest. Ops.
Phone # (615) 444-5533

Designated Agent(s):

Michael Zylstra
305 Hartmann Drive
PO Box 787
Lebanon, Tennessee 370880787
Title: VP, GC & Corp. Sec.
Phone # (615) 235-4066

Banks or Depositories

Wilson Bank & Trust
623 West Main Street
Lebanon, Tennessee 37087

Signed: Mr. Charlie Austin
Date Signed: 12/31/2013

FORM TEXT

(End FEC FORM 1)

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