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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-455291

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1. Molina Healthcare, Inc. PAC

    200 Oceangate
    Suite 100
    Long Beach, CA 90802
    Email: margie.finkelnburg@molinahealthcare.com

2. Date: 03/11/2010

3. FEC Committee ID #: C00430256 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

Molina Healthcare Inc
200 Oceangate Blvd
Suite 100
Long Beach, California 90802
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Margie Finkelnburg
1100 New York Avenue, NW
Suite 1080 West
Washington, DC 20005
Title: Director, Grassroots
Phone # (202) 639-9868

Treasurer:

Mr. Michael Mayers
300 University Blvd
Suite 100
Sacramento, California 95825
Title: VP, Policy & Govt Ad
Phone # (916) 646-4666

Designated Agent(s):

Margie Finkelnburg
1100 new York Avenue, NW
Suite 1080 West
Washington, DC 20005
Title: Director, Grassroots
Phone # (202) 639-9868

Banks or Depositories

EastWestBank
23737 Hawthorne Blvd
Torrance, California 90505

Signed: Michael Mayers
Date Signed: 03/11/2010

(End FEC FORM 1)

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