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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-751779

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1. Planned Parenthood Action Fund Inc. PAC

    434 West 33rd Street
    New York, NY 10001
    Email: fecinfo@PASS1.com

    NOTE: Email address is different than previously reported

2. Date: 11/04/2011

3. FEC Committee ID #: C00314617 This committee is a separate segregated fund. Its connected organization is a Membership Organization
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Committee ID# C90005471
Planned Parenthood Action Fund Inc.
434 West 33rd Street
New York, New York 10001
Affiliated Relationship Code: Connected Organization

Committee ID# C00312082
Planned Parenthood of Houston & Southe
3601 Fannin
Houston, Texas 77004
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Aaron Samulcek
434 West 33rd Street
New York, NY 10001
Title: Custodian
Phone # (212) 261-4749

Treasurer:

Aaron Samulcek
434 West 33rd Street
New York, New York 10001
Title: Treasurer
Phone # (212) 261-4749

Designated Agent(s):

Lynda Feldman
434 West 33rd Street
New York, New York 10001
Title: Assistant Treasurer
Phone # (212) 247-6275

Banks or Depositories

The Bank of New York
One Wall Street
New York, New York 10286

Signed: Aaron Samulcek
Date Signed: 11/04/2011

FORM TEXT

(End FEC FORM 1)

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