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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1361798

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1. CVS Health PAC

    1275 Pennsylvania Avenue, NW
    Suite 700
    Washington, DC 20004
    Email: Kelly.Fink@CVSHealth.com

    NOTE: Email address is different than previously reported

2. Date: 11/06/2019

3. FEC Committee ID #: C00384818 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

CVS Health
1 CVS Drive
Woonsocket, Rhode Island 02895
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Kelly Fink
1275 Pennsylvania Avenue, NW, Suit
Washington, DC 20004
Title: PAC Treasurer
Phone # (703) 687-7982

Designated Agent(s):

Tracy Smith
1 CVS Drive
Woonsocket, Rhode Island 02895
Title: Assistant Treasurer

Banks or Depositories

Wells Fargo Bank
420 Montgomery Street
San Francisco, California 94104

Signed: Kelly Fink
Date Signed: 11/06/2019

(End FEC FORM 1)

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