FEC Form 1 for H&R Block Inc. Political Action Committee (BLOCKPAC)Form 1 for H&R Block Inc. Political Action Committee (BLOCKPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1001864

1. H&R Block Inc. Political Action Committee (BLOCKPAC)

One H&R Block Way
Kansas City, MO 64105
Email: jeremy.stohs@hrblock.com

2. Date: 04/10/2015

3. FEC Committee ID #: C00188177 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

H&R Block Inc.
One H&R Block Way
Kansas City, Missouri 64105
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Andrew Jennison
1401 Eye Street
Suite 240
Washington, DC 20005
Title: Custodian of Records
Phone # (202) 962-0075

Treasurer:

Jeremy Stohs
One H&R Block Way
Kansas City, Missouri 64105
Title: Treasurer
Phone # (816) 854-6207

Designated Agent(s):

Banks or Depositories

Bank of America
P.O. Box 798
Wichita, Kansas 67201

Signed: Jeremy Stohs
Date Signed: 04/10/2015

FORM TEXT-1

(End FEC FORM 1)

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