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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-843128

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1. Hospira Inc PAC LLC

    275 North Field Drive
    H1-4S Dept GVAF
    Lake Forest, IL 60045
    Email: juliana.reed@hospira.com

2. Date: 12/27/2012

3. FEC Committee ID #: C00433284 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Hospira, Inc.
275 North Field Drive
Lake Forest, Illinois 60045
Affiliated Relationship Code: Connected Organization

Custodian of Records:

James M. Ellis
2147 Silver Linden
Buffalo Grove, IL 60089
Title: Sr. Counsel
Phone # (224) 212-2866

Treasurer:

Mike Chialdikas
1081 Memory Lane
Lake Zurich, Illinois 60047
Title: VP and Treasurer
Phone # (224) 212-3257

Designated Agent(s):

Banks or Depositories

Citibank N.A.
111 Wall Street
New York, New York 10043

Signed: Mike Chialdikas
Date Signed: 12/27/2012

(End FEC FORM 1)

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