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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-98374

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1. C. R. Bard Inc. Active Citizenship Committee

    730 Central Avenue
    Murray Hill, NJ 07974
    Email: pacs@pass1.com

2. Date: 10/10/2003

3. FEC Committee ID #: C00359125 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

C. R. Bard Inc.
730 Central Avenue
Murray Hill, New Jersey 07974
Relationship: Connected
Organization Type: Corporation

Custodian of Records:

Mr. Todd Schermerhorn
c/o PASS
1020 North Fairfax Street
Alexandria, VA 22314
Title: CFO
Phone # (908) 277-8139

Treasurer:

Mr. Todd Schermerhorn
730 Central Avenue
Murray Hill, New Jersey 07974
Title: CFO
Phone # (908) 277-8139

Designated Agent(s):

Scott Lowry
730 Central Avenue
Murray Hill, New Jersey 07974
Title: Assistant Treasurer
Phone # (908) 277-8265

Banks or Depositories

Fleet Bank
15 South Street
New Providence, New Jersey 07974

Signed: Mr. Todd Schermerhorn
Date Signed: 10/15/2003

(End FEC FORM 1)

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