FEC Form 1 for The Atkins North America Holdings Corporation PACForm 1 for The Atkins North America Holdings Corporation PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-754422

1. The Atkins North America Holdings Corporation PAC

4030 West Boy Scout Boulevard
Suite 700
Tampa, FL 33607
Email: slruhl@comerica.com

2. Date: 12/08/2011

3. FEC Committee ID #: C00385989 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

The Atkins North America Holdings Corporation
4030 West Boy Scout Boulevard
Suite 700
Tampa, Florida 33607
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Comerica Bank
PAC Services, MC 2250
PO Box 75000
Detroit, MI 482752250
Title: Recordkeeper
Phone # (248) 371-7269

Treasurer:

Catherine Cahill
4030 West Boy Scout Boulevard
Suite 700
Tampa, Florida 33607
Title: Treasurer
Phone # (305) 514-3724

Designated Agent(s):

Tanya M. Shim
4030 West Boy Scout Boulevard
Suite 700
Tampa, Florida 33607
Title: Assistant Treasurer
Phone # (813) 281-8635

Nancy Cushman
PO Box 75000
MC 2250
Detroit, Michigan 482752250
Title: Assistant Treasurer
Phone # (248) 371-7269

Banks or Depositories

Comerica Bank
PAC Services, MC 2250
P.O. Box 75000
Detroit, Michigan 482752250

Signed: Catherine Cahill
Date Signed: 12/08/2011

FORM TEXT

(End FEC FORM 1)

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