FEC Form 1 for Tyco International Management Company PACForm 1 for Tyco International Management Company PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-454728

1. Tyco International Management Company PAC

9 Roszel Road
Princeton, NJ 08540
Email: cbennett@tyco.com

2. Date: 03/02/2010

3. FEC Committee ID #: C00113753 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

Tyco International Management Company
9 Roszel Road
Princeton, New Jersey 08540
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Catherine Bennett
9 Roszel Road
Princeton, NJ 08540
Title: Custodian of Records
Phone # (202) 350-6900

Treasurer:

Ademir Sarcevic
9 Roszel Road
Princeton, New Jersey 08540
Title: Treasurer
Phone # (609) 720-4200

Designated Agent(s):

Manpreet Grewal
9 Roszel Road
Princeton, New Jersey 08540
Title: Assistant Treasurer
Phone # (609) 720-4200

Banks or Depositories

Bank of America
7810 Old Branch Ave
Clinton, Maryland 20735

Signed: Mr. Ademir Sarcevic
Date Signed: 03/02/2010

(End FEC FORM 1)

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