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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1031338

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1. Swedish Match North America, Inc. PAC

    1021 East Cary Street
    STE 1600
    Richmond, VA 23219

    NOTE: Address is different than previously reported

    Email: harry.benz@swedishmatch.com;wanda.blake@swedishmatch.com

    NOTE: Email address is different than previously reported

2. Date: 10/26/2015

3. FEC Committee ID #: C00215053 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Swedish Match North America, Inc.
1021 E Cary Street
STE 1600
Richmond, Virginia 23219
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Devon Jones
6305 Jahodi Lane
Henrico, VA 23231
Title: Custodian of Records
Phone # (804) 787-5176

Treasurer:

WANDA BLAKE
14531 Waters Shore Drive
Midlothian, Virginia 23112
Title: Treasurer
Phone # (804) 787-5109

Designated Agent(s):

Harry Benz
11130 Lyndenwood Drive
Chesterfield, Virginia 23838
Title: Assistant Treasurer
Phone # (804) 787-5108

Banks or Depositories

Wells Fargo Bank
1021 East Cary Street
Richmond, Virginia 23219

Signed: WANDA BLAKE
Date Signed: 10/28/2015

FORM TEXT-1

(End FEC FORM 1)

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