FEC Form 1 for HERBALIFE PACForm 1 for HERBALIFE PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-708793

1. HERBALIFE PAC

990 West 190th Street
Torrance, CA 90502
Email: sarceneaux@politicalcompliance.com

2. Date: 01/26/2011

3. FEC Committee ID #: C00393298 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

Herbalife International Inc.
800 W. Olympic Blvd
Los Angeles, California 90015
Affiliated Relationship Code: Connected Organization

Custodian of Records:

John Venardos
990 West 190th Street
Suite 650
Torrance, CA 90502
Title: Secretary
Phone # (310) 410-9600

Treasurer:

John DeSimone
990 West 190th Street
Suite 650
Torrance, California 90502
Title: Treasurer
Phone # (310) 410-9600

Designated Agent(s):

Tom Darcy
Herbalife International
800 W. Olympic Blvd
Los Angeles, California 90015
Title: Assistant Treasurer
Phone # (310) 410-9600

Bosco Chiu
990 West 190th Street
Suite 650
Torrance, California 90502
Title: Assistant Treasurer
Phone # (310) 410-9600

David Pezzullo
Herbalife International
800 W. Olympic Blvd
Los Angeles, California 90015
Title: Assistant Treasurer
Phone # (310) 410-9600

Banks or Depositories

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

Signed: John DeSimone
Date Signed: 01/26/2011

(End FEC FORM 1)

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