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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-998839

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

    920 Massachusetts Ave, NW
    Suite 500
    Washington, DC 20001

    NOTE: Address is different than previously reported

    Email: shno@novonordisk.com;CMCG@novonordisk.com

2. Date: 03/19/2015

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
Princeton, New Jersey 08536
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Lauren Semeniuk
Massachusetts Ave, NW
Ste 500
Washington, DC 20001
Title: Custodian of Records
Phone # (202) 626-4531

Treasurer:

Mr. Christopher Porter
920 Massachusetts Ave, NW
Suite 500
Washington, DC 20001
Title: Treasurer
Phone # (202) 626-4524

Designated Agent(s):

Kevin Ryan
920 Massachusetts Ave, NW
Ste 500
Washington, DC 20001
Title: Asst. Treasurer
Phone # (202) 626-4524

Banks or Depositories

Wells Fargo
444 N Capitol Street NW
Washington, DC 20001

Signed: Mr. Christopher Porter
Date Signed: 03/19/2015

(End FEC FORM 1)

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