FEC Form 1 for OSI SYSTEMS INC PAC OSI PACForm 1 for OSI SYSTEMS INC PAC OSI PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-407300

1. OSI SYSTEMS INC PAC OSI PAC

1530 WILSON BLVD SUITE 170
ARLINGTON, VA 22209
Email: osi-pac@osi-systems.com

2. Date: 03/12/2009

3. FEC Committee ID #: C00414896 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

OSI Systems Inc.
12525 Chadron Ave.
Hawthorne, California 90250
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Victor Sze
3232 W. Segundo Blvd.
Hawthorne, CA 90250
Title: Assistant Treasurer
Phone # (310) 978-0516

Treasurer:

Peter Kant
226 N. Garfield St.
Arlington, Virginia 22201
Title: Treasurer
Phone # (703) 812-0322

Designated Agent(s):

Victor Sze
3232 W. Segundo Blvd.
Hawthorne, California 90250
Title: Assistant Treasurer
Phone # (310) 978-0516

Banks or Depositories

Bank of the West
300 S. Grand Ave, Suite 700
Los Angeles, California 90071

Signed: Peter Kant
Date Signed: 03/12/2009

(End FEC FORM 1)

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