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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1097498

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1. J. R. Simplot Company Political Action Committee

    999 Main Street
    Boise, ID 83702
    Email: cindy.bennett@simplot.com

    NOTE: Email address is different than previously reported

2. Date: 05/25/2016

3. FEC Committee ID #: C00120873 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

J.R. Simplot Company
PO Box 27
Boise, Idaho 837070027
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Joel Barker
972 Cove Colony
Eagle, Idaho 83616
Title: SR VP CFO/TREASURER
Phone # (208) 336-2110

Designated Agent(s):

Banks or Depositories

Wells Fargo Bank
877 W Main St
Boise, Idaho 83702

Signed: Joel Barker
Date Signed: 08/31/2016

(End FEC FORM 1)

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