FEC Form 1 for Roche Inc. Good Government CommitteeForm 1 for Roche Inc. Good Government Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-496323

1. Roche Inc. Good Government Committee

340 Kingsland Street
Nutley, NJ 071101199

2. Date: 10/05/2010

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 Inc.
340 Kingsland Street
Nutley, New Jersey 07110
Affiliated Relationship Code: Connected Organization

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

Custodian of Records:

Debbie Welsh
340 Kingsland St.
Nutley, NJ 07110
Title: Custodian of Records
Phone # (202) 296-7272

Treasurer:

David McDede
340 Kingsland Street
Nutley, New Jersey 07110
Title: Treasurer
Phone # (973) 235-3652

Designated Agent(s):

Banks or Depositories

Wachovia
Dept. VA7300
P.O. Box 40031
Roanoke, Virginia 240220031

Signed: David McDede
Date Signed: 10/05/2010

(End FEC FORM 1)

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