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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-973524

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

    300 New Jersey Avenue NE
    Suite 600
    Washington, DC 20001

    NOTE: Address is different than previously reported

    Email: asong@express-scripts.com;jhouts@express-scripts.com

    NOTE: Email address is different than previously reported

2. Date: 11/24/2014

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

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

Custodian of Records:

Mr. Jonah Houts
300 New Jersey Ave., NW
Suite 600
Washington, DC 20001
Title: Custodian of Records
Phone # (202) 383-7983

Treasurer:

Timothy Smith
300 New Jersey Ave NW
Suite 600
Washington, DC 20001
Title: Treasurer
Phone # (314) 684-5759

Designated Agent(s):

Michelle Mack
300 New Jersey Ave NW
Suite 600
Washington, DC 20001
Title: Assistant Treasurer
Phone # (952) 837-5103

Timothy Smith
300 New Jersey Ave NW
Suite 600
Washington, DC 20001
Title: Treasurer
Phone # (314) 684-5759

Michelle Mack
300 New Jersey Ave NW
Suite 600
Washington, DC 20001
Title: Assistant Treasurer
Phone # (952) 837-5103

Banks or Depositories

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

Signed: Timothy Smith
Date Signed: 11/24/2014

(End FEC FORM 1)

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