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FEC Form 1 for OSI SYSTEMS INC PAC OSI PACForm 1 for OSI SYSTEMS INC PAC OSI PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-428769


1. OSI SYSTEMS INC PAC OSI PAC

    1530 WILSON BLVD SUITE 170
    ARLINGTON, VA 22209
    Email: osi-pac@osi-systems.com

2. Date: 08/04/2009

3. FEC Committee ID #: C00414896 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

OSI Systems Inc.
12525 Chadron Ave.
Hawthorne, California 90250
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Victor Sze
3232 W. Segundo Blvd.
Hawthorne, CA 90250
Title: Assistant Treasurer
Phone # (310) 978-0516

Treasurer:

Peter Kant
226 N. Garfield St.
Arlington, Virginia 22201
Title: Treasurer
Phone # (703) 812-0322

Designated Agent(s):

Victor Sze
3232 W. Segundo Blvd.
Hawthorne, California 90250
Title: Assistant Treasurer
Phone # (310) 978-0516

Banks or Depositories

Bank of America
1655 Grant Street
Concord, California 94520

Signed: Peter Kant
Date Signed: 08/04/2009

(End FEC FORM 1)


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