FEC Form 1 for EXPRESS SCRIPTS INC. POLITICAL FUND (A/K/A EXPRESS SCRIPTS PAC)Form 1 for EXPRESS SCRIPTS INC. POLITICAL FUND (A/K/A EXPRESS SCRIPTS PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-784321

1. EXPRESS SCRIPTS INC. POLITICAL FUND (A/K/A EXPRESS SCRIPTS PAC)

One Express Way
St. Louis, MO 63121
Email: mmack1@express-scripts.com

2. Date: 05/16/2012

3. FEC Committee ID #: C00365072 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

Express Scripts, Inc
One Express Way
St. Louis, Missouri 63121
Affiliated Relationship Code: Connected Organization

Committee ID# C00384362
MEDCO HEALTH SOLUTIONS, INC. AND EXPRE
2350 Kerner Blvd.
Suite 250
San Rafael, California 94901
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Mary M. Rosado
300 New Jersey Avenue, NW
Suite 600
Washington, DC 20001
Title: Custodian of Records
Phone # (202) 383-7984

Treasurer:

Kelley Elliott
One Express Way
Maryland Heights, Missouri 63043
Title: Treasurer
Phone # (314) 810-3152

Designated Agent(s):

Banks or Depositories

US Bank
1 US Bank Plaza
7th and Washington
St. Louis, Missouri 63101

Signed: Kelley Elliott
Date Signed: 05/16/2012

(End FEC FORM 1)

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