FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-184379
1. PURDUE PHARMA INC. POLITICAL ACTION COMMITTEE (PURDUE PAC)
c/o Henry Shaw CPA P.C.106 Corporate Park Dr. Suite 307
White Plains, NY 106043819
Email: joseph.drelich@pharma.com
2. Date: 08/16/2005
3. FEC Committee ID #: C00370643 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Purdue Pharma Inc.One Stamford Forum
Stamford, Connecticut 069013431
Relationship: Connected
Organization Type: Corporation
Custodian of Records:
Joseph DrelichOne Stamford Forum
Stamford, CT 069013431
Title: Treasurer
Phone # (203) 588-8000
Treasurer:
Joseph DrelichOne Stamford Forum
Stamford, Connecticut 069013431
Title: Treasurer
Phone # (203) 588-8000
Designated Agent(s):
Timothy BannonOne Stamford Forum
Stamford, Connecticut 069013431
Title: Assistant Treasurer
Phone # (203) 588-8000
Banks or Depositories
JP Morgan Chase Bank1411 Broadway
New York, New York 10018
UBS Financial Services Inc.
1735 Market St. 36th Floor
Philadelphia, Pennsylvania 191037501