FEC Form 1 for Nestle Waters North America Inc. PACForm 1 for Nestle Waters North America Inc. PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-996661

1. Nestle Waters North America Inc. PAC

900 Long Ridge Rd. Building 2
Stamford, CT 069021138
Email: raymond.donahue@waters.nestle.com

2. Date: 03/06/2015

3. FEC Committee ID #: C00302943 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

Nestle Waters North America Inc.
900 Long Ridge Rd. Building 2
Stamford, Connecticut 069021138
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Raymond Donahue
900 Long Ridge Road
Stamford, CT 06902
Title: Custodian of Records
Phone # (203) 863-0318

Treasurer:

Raymond Donahue
900 Long Ridge Road
Stamford, Connecticut 06902
Title: Treasurer
Phone # (203) 863-0318

Designated Agent(s):

Scott Bucci
900 Long Ridge Rd. Building 2
Stamford, Connecticut 06902
Title: Assistant Treasurer
Phone # (203) 863-0361

Banks or Depositories

Bank of America
433 Boston Post Rd.
Port Chester, New York 10573

Signed: Raymond Donahue
Date Signed: 03/06/2015

FORM TEXT-1

(End FEC FORM 1)

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