FEC Form 1 for Zeneca Inc. Political Action CommitteeForm 1 for Zeneca Inc. Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-705077

1. Zeneca Inc. Political Action Committee

c/o Zeneca Inc.
1800 Concord Pike, PO Box 15437
Wilmington, DE 19850
Email: kelly.rolison@astrazeneca.com

2. Date: 01/11/2011

3. FEC Committee ID #: C00279455 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

Zeneca Inc.
1800 Concord Pike
PO Box 15437
Wilmington, Delaware 19850
Affiliated Relationship Code: Connected Organization

MedImmune Biologics, Inc. Employee Pol
One MedImmune Way
Gaithersburg, Maryland 20878
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Kelly J. Rolison
1800 Concord Pike
PO Box 15437
Wilmington, DE 19850
Title: Treasurer
Phone # (302) 886-7517

Treasurer:

Kelly J. Rolison
1800 Concord Pike
PO Box 15437
Wilmington, Delaware 19850
Title: Treasurer
Phone # (302) 886-7517

Designated Agent(s):

Jeff Penza
1800 Concord Pike
Wilmington, Delaware 19850
Title: Assistant Treasurer
Phone # (302) 885-9260

Banks or Depositories

Wachovia Bank
PO Box 248
Attention: Account Inquiries
Upper Darby, Pennsylvania 190820248

Signed: Kelly J. Rolison
Date Signed: 01/11/2011

(End FEC FORM 1)

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