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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-741516

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1. DAVITA INC POLITICAL ACTION COMMITTEE ('DAVITA')

    601 Hawaii Street
    El Segundo, CA 90245
    Email: davitapac@gmail.com

2. Date: 08/12/2011

3. FEC Committee ID #: C00340943 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

DaVita, Inc.
601 Hawaii Street
El Segundo, California 90245
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Lin Whatcott
1423 Pacific Avenue, Tacoma
Tacoma, WA 98402
Title: Sr. Director of Corp
Phone # (253) 280-9506

Treasurer:

Lin Whatcott
1423 Pacific Avenue
Tacoma, Washington 98402
Title: Sr. Director of Corp
Phone # (253) 280-9506

Designated Agent(s):

Banks or Depositories

Wachovia Bank, NA
1525 West W T Harris Blvd.
Charlotte, North Carolina 28262

Signed: Lin Whatcott
Date Signed: 08/12/2011

FORM TEXT

(End FEC FORM 1)

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