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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1141386

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1. Wal-Mart Stores Inc. PAC For Responsible Government

    702 S.W. 8th Street
    Bentonville, AR 727160150
    Email: timothy.foltyn@walmart.com

    NOTE: Email address is different than previously reported

2. Date: 01/25/2017

3. FEC Committee ID #: C00093054 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

Wal-Mart Stores Inc.
702 S.W. 8th Street
Bentonville, Arkansas 727160150
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Timothy J. Foltyn
701 8th Street, NW
Second Floor
Washington, DC 20001
Title: Assistant Treasurer
Phone # (202) 434-0718

Treasurer:

Daniel Bryant
701 8th Street, NW
Second Floor
Washington, DC 20001
Title: Treasurer
Phone # (202) 434-0999

Designated Agent(s):

Timothy J. Foltyn
701 8th Street, NW
Second Floor
Washington, DC 20001
Title: Assistant Treasurer
Phone # (202) 434-0718

Banks or Depositories

Arvest Bank
P.O. Box 1229
Bentonville, Arkansas 72712

Signed: Daniel Bryant
Date Signed: 01/25/2017

(End FEC FORM 1)

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