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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-347076

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1. Headwaters Incorporated PAC

    10653 S. River Front Parkway
    Suite 300
    South Jordan, UT 84095
    Fax: 8019849410
    Email: sballard@headwaters.com

2. Date: 07/03/2008

3. FEC Committee ID #: C00388751 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Headwaters Inc.
10653 S River Front Parkway
Suite 300
South Jordan, Utah 84095
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Scott Ballard
10653 S River Front Parkway
Suite 300
South Jordan, UT 84095
Title: Treasurer/Headwaters
Phone # (801) 984-9400

Treasurer:

Mr. Scott Ballard
10653 S River Front Parkway
Suite 300
South Jordan, Utah 84095
Title: Treasurer/Headwaters
Phone # (801) 984-9400

Designated Agent(s):

Banks or Depositories

Zions First National Bank
125 West 10600 South
Sandy, Utah 84070

Wells Fargo Bank, NA
834 East 9400 South
Sandy, Utah 84094

Signed: Mr. Scott Ballard
Date Signed: 07/03/2008
Official Committee FAX: 8019849410

(End FEC FORM 1)

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