FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-703628
1. The Nestle Waters North America Inc. Political Action Committee
900 Long Ridge Rd. Building 2Stamford, CT 069021138
NOTE: Address is different than previously reported
Email: kevin.kolanda@waters.nestle.comNOTE: Email address is different than previously reported
2. Date: 12/30/2010
3. FEC Committee ID #: C00302943 This committee is a separate segregated fund. Its connected organization is a CorporationIn addition, this committee is a Lobbyist/Registrant PAC.
Affiliated Committees/Organizations
Nestle Waters North America Inc.900 Long Ridge Rd. Building 2
Stamford, Connecticut 06902
Affiliated Relationship Code: Connected Organization
Committee ID# C00382119
Nestle Purina PetCare Co PAC
Checkboard Square
St. Louis, Missouri 63164
Affiliated Relationship Code: Affiliated Committee
Custodian of Records:
Kevin Kolanda900 Long Ridge Rd. Building 2
Stamford, CT 06902
Title: Custodian
Phone # (203) 276-5852
Treasurer:
Kevin Kolanda900 Long Ridge Rd. Building 2
Stamford, Connecticut 06902
Title: Treasurer
Phone # (203) 276-5852
Designated Agent(s):
Robert Schaab900 Long Ridge Rd. Building 2
Stamford, Connecticut 06902
Title: Assistant Treasurer
Phone # (203) 629-7232
Banks or Depositories
Bank of America433 Boston Post Rd.
Port Chester, New York 10573