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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1023625

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1. Omnicare, Inc. Political Action Committee

    900 Omnicare Center
    201 East 4th Street
    Cincinnati, OH 45202
    Email: donna.lecky@omnicare.com

2. Date: 08/28/2015

3. FEC Committee ID #: C00392886 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

Omnicare, Inc.
900 Omnicare Center
201 East 4th Street
Cincinnati, Ohio 45202
Affiliated Relationship Code: Connected Organization

Committee ID# C00384818
CVS HEALTH PAC
1275 PENNSYLVANIA AVENUE, NW
SUITE 700
WASHINGTON, DC 20004
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Donna Lecky
900 Omnicare Center
201 East 4th Street
Cincinnati, OH 45202
Title: Treasurer
Phone # (513) 719-2600

Treasurer:

Donna Lecky
900 Omnicare Center
201 East 4th Street
Cincinnati, Ohio 45202
Title: Treasurer
Phone # (513) 719-2600

Designated Agent(s):

Banks or Depositories

U.S. Bank
425 Walnut Street
Cincinnati, Ohio 45202

Signed: Donna Lecky
Date Signed: 08/28/2015

(End FEC FORM 1)

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