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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-410016

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1. Medtronic Inc. Medical Technology Fund

    950 F Street NW Suite 500
    Washington, DC 20004

    NOTE: Address is different than previously reported

    Email: CFS@PASS1.com

2. Date: 03/27/2009

3. FEC Committee ID #: C00311878 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

Medtronic Inc.
710 Medtronic Parkway NE
Minneapolis, Minnesota 55482
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Peter B Slone
1300 Pennsylvania Ave. NW Suite 38
0
Washington, DC 20004
Title: Custodian

Treasurer:

Gary Ellis
710 Medtronic Parkway NE
Minneapolis, Minnesota 55482
Title: Treasurer
Phone # (763) 505-2770

Designated Agent(s):

Banks or Depositories

Bank of America N.A.
P.O. Box 27128
Concord, California 94520

Signed: Gary Ellis
Date Signed: 03/27/2009

FORM TEXT-1

(End FEC FORM 1)

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