FEC Form 1 for HERBALIFE INTERNATIONAL INC. POLITICAL ACTION COMMITTEE (AKA HERBALIFEPAC)Form 1 for HERBALIFE INTERNATIONAL INC. POLITICAL ACTION COMMITTEE (AKA HERBALIFEPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-137425

1. HERBALIFE INTERNATIONAL INC. POLITICAL ACTION COMMITTEE (AKA HERBALIFEPAC)

1800 CENTURY PARK EAST
CENTURY CITY, CA 90067

2. Date: 09/28/2004

3. FEC Committee ID #: C00393298 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Herbalife International Inc.
1800 Century Park East
Century City, California 90067
Relationship: Connected Organizati
Organization Type: Corporation

Custodian of Records:

John Vernardos
1800 Century Park East
Century City, CA 90067
Title: Secretary
Phone # (310) 203-7746

Treasurer:

William D. Lowe
1800 Century Park East
Century City, California 90067
Title: Treasurer
Phone # (310) 203-7746

Designated Agent(s):

Tom Darcy
1800 Century Park East
Century City, California 90067
Title: Assistant Treasurer
Phone # (310) 203-7746

Jesper Rathje
1800 Century Park East
Century City, California 90067
Title: Assistant Treasurer
Phone # (310) 203-7746

Banks or Depositories

Union Bank of California
445 South Figueroa Street
Los Angeles, California 90071

Signed: William D. Lowe
Date Signed: 10/08/2004

(End FEC FORM 1)

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