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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1603865

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1. Novo Nordisk Inc. PAC (Novo Nordisk PAC)

    1000 F Street, NW
    Fourth Floor
    Washington, DC 20004

    NOTE: Address is different than previously reported

    Email: klcu@novonordisk.com;shyr@novonordisk.com

    NOTE: Email address is different than previously reported

2. Date: 06/13/2022

3. FEC Committee ID #: C00424838 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

Novo Nordisk Inc.
800 Scudders Mill Road
Plainsboro, New Jersey 08536
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Kara Stewart
1000 F Street, NW
Fourth Floor
Washington, DC 20004
Title: Custodian of Records
Phone # (202) 626-5635

Treasurer:

Shoeb Hyder
800 Scudders Mill Road
Plainsboro, New Jersey 08536
Title: Treasurer
Phone # (908) 887-0943

Designated Agent(s):

Brian Branton
1000 F Street, NW
Fourth Floor
Washington, DC 20004
Title: Assistant Treasurer
Phone # (202) 626-5637

Banks or Depositories

Wells Fargo
444 N Capitol Street NW
Washington, DC 20001

Signed: Shoeb Hyder
Date Signed: 06/13/2022

(End FEC FORM 1)

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