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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-118377

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1. Medtronic Inc. Medical Technology Fund

    1420 New York Avenue NW Suite 600
    Washington, DC 20005

    NOTE: Address is different than previously reported

    Fax: 202-393-0444
    Email: cfs@pass1.com

2. Date: 04/27/2004

3. FEC Committee ID #: C00311878 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Medtronic Inc.
710 Medtronic Parkway NE
Minneapolis, Minnesota 55482
Relationship: Connected Corporation
Organization Type: Corporation

Custodian of Records:

Peter B. Slone
1420 New York Ave. NW Suite 600
Washington, DC 20005
Title: Custodian of Records
Phone # (202) 393-0444

Treasurer:

Gary Ellis
710 Medtronic Parkway NE
Minneapolis, Minnesota 55482
Title: Treasurer
Phone # (763) 505-2770

Designated Agent(s):

Banks or Depositories

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

Signed: Gary Ellis
Date Signed: 04/27/2004
Official Committee URL: n/a
Official Committee FAX: 202-393-0444

(End FEC FORM 1)

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