FEC Form 1 for Teva Pharmaceuticals USA, Inc. Political Action CommitteeForm 1 for Teva Pharmaceuticals USA, Inc. Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-755742

1. Teva Pharmaceuticals USA, Inc. Political Action Committee

25 Massachusetts Avenue, NW
Suite 440
Washington, DC 20001
Email: marva.gray@tevapharm.com

NOTE: Email address is different than previously reported

2. Date: 12/21/2011

3. FEC Committee ID #: C00434811 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

Teva Pharmaceuticals USA Inc.
1090 Horsham Road
North Wales, Pennsylvania 19454
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Marva Gray
25 Massachusetts Ave., NW
Suite 440
Washington, DC 20001
Title: Custodian of Records
Phone # (202) 639-3800

Treasurer:

Deborah Alice Griffin
1090 Horsham Road
North Wales, Pennsylvania 19454
Title: Treasurer/Custodian
Phone # (215) 591-3000

Designated Agent(s):

Banks or Depositories

PNC Bank
1600 Market Street
Philadelphia, Pennsylvania 19103

Signed: Deborah Alice Griffin
Date Signed: 12/21/2011

(End FEC FORM 1)

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