FEC Form 1 for Baxter Healthcare Corporation Political Action CommitteeForm 1 for Baxter Healthcare Corporation Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1008728

1. Baxter Healthcare Corporation Political Action Committee

NOTE:Commmittee Name is different than previously reported

901 15th Street, NW
Suite 500
Washington, DC 20005

NOTE: Address is different than previously reported

Email: Mariko_Bennett@Baxter.com;Kendra.Crowley@Skadden.com

NOTE: Email address is different than previously reported

2. Date: 05/20/2015

3. FEC Committee ID #: C00117838 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

Baxter Healthcare Corporation
1 Baxter Parkway
Deerfield, Illinois 60015
Affiliated Relationship Code: Connected Organization

Baxter Healthcare Corporation Baxalta
901 15th Street, NW
Suite 500
Washington, DC 20005
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Treasurer:

Sarah Creviston
901 15th Street, NW
Suite 500
Washington, DC 20005
Title: Treasurer
Phone # (202) 508-8206

Designated Agent(s):

Banks or Depositories

JPMorgan Chase Bank, N.A.
P.O. Box 659754
San Antonio, Texas 782659754

Signed: Sarah Creviston
Date Signed: 05/20/2015

(End FEC FORM 1)

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