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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-715602

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1. CBC COMPANIES INC PAC

    250 EAST TOWN STREET
    COLUMBUS, OH 43215
    Email: cbcpac@cbc-companies.com

2. Date: 02/21/2011

3. FEC Committee ID #: C00410001 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

Committee ID# C00410001
CBC COMPANIES INC PAC
250 EAST TOWN STREET
COLUMBUS, Ohio 43215
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Dirk Mason Cantrell
250 East Town Street
Columbus, OH 43215
Title: Treasurer
Phone # (614) 222-5414

Treasurer:

Mr. Dirk Mason Cantrell
250 East Town Street
Columbus, Ohio 43215
Title: Treasurer
Phone # (614) 222-5414

Designated Agent(s):

Jonathan Price
1651 NW Professional Plaza
Columbus, Ohio 43220
Title: Asst Treasurer
Phone # (614) 222-4084

Banks or Depositories

JPMorgan Chase Bank
100 East Broad Street
Columbus, Ohio 43215

Signed: Mr. Dirk Mason Cantrell
Date Signed: 02/21/2011

(End FEC FORM 1)

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