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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1190571

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1. ALLERGAN, INC. POLITICAL ACTION COMMITTEE

    5 Giralda Farms
    Madison, NJ 07940

    NOTE: Address is different than previously reported

    Email: debbie.huang@allergan.com;keichin.huang@allergan.com

2. Date: 11/01/2017

3. FEC Committee ID #: C00391086 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

Allergan, Inc.
5 Giralda Farms
Madison, New Jersey 07940
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Debbie Huang
2525 Dupont
Irvine, CA 92612
Title: Custodian of Records
Phone # (714) 246-2527

Treasurer:

Robert Lively
500 N. Capitol St NW, Suite 330
Washington, DC 20001
Title: Treasurer
Phone # (202) 644-5336

Designated Agent(s):

Brenton Fisk
500 N. Capitol St. NW, Suite 330
Washington, DC 20001
Title: Assistant Treasurer

Banks or Depositories

Union Bank
455 S. Figueroa Street
Los Angeles, California 90071

Signed: Robert Lively
Date Signed: 11/08/2017

(End FEC FORM 1)

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