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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1520712

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1. Roche Diagnostics Corporation PAC (Roche DxPAC)

    Roche
    9115 Hague Rd
    Indianapolis, IN 46256

    NOTE: Address is different than previously reported

    Email: washington.dxpac@roche.com

    NOTE: Email address is different than previously reported

2. Date: 06/14/2021

3. FEC Committee ID #: C00072769 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

Roche Diagnostics Corporation
9115 Hague Road
Indianapolis, Indiana 46256
Affiliated Relationship Code: Connected Organization

Genentech Inc. Political Action Commit
1 DNA Way
MS355A
South San Francisco, California 94080
Affiliated Relationship Code: Affiliated Committee

Spark Therapeutics, Inc. PAC (Spark PA
3737 Market Street
Suite 1300
Philadelphia, Pennsylvania 19104
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Taylor Cagle
9115 Hague Rd.
Indianapolis, IN 46256
Title: Custodian of Records
Phone # (317) 946-8159

Treasurer:

Robyn A. Poole
9115 Hague Rd.
Indianapolis, Indiana 46256
Title: Treasurer
Phone # (317) 263-4080

Designated Agent(s):

Taylor Cagle
9115 Hague Rd.
Indianapolis, Indiana 46256
Title: Assistant Treasurer
Phone # (317) 946-8159

Banks or Depositories

Citibank
One Penns Way
New Castle, Delaware 19720

Signed: Robyn A. Poole
Date Signed: 06/14/2021

(End FEC FORM 1)

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