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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1300860

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1. Idemia Identity & Security LLC Political Action Committee

    296 Concord Rd
    Suite 300
    Billerica, MA 01821
    Email: Ben.Mallen@us.idemia.com;jamie.gagnon@us.idemia.com

    NOTE: Email address is different than previously reported

2. Date: 12/12/2018

3. FEC Committee ID #: C00437491 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

Idemia Identity & Security LLC
296 Concord Road
Suite 300
Billerica, Massachusetts 01821
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Ben Mallen
296 Concord Rd
Billerica, MA 01821
Title: Treasurer
Phone # (978) 215-2808

Treasurer:

Ben Mallen
296 Concord Rd
Billerica, Massachusetts 01821
Title: Treasurer
Phone # (978) 215-2808

Designated Agent(s):

Jamison Gagnon
296 Concord Road
Suite 300
Billerica, Massachusetts 01821
Title: Assistant Treasurer
Phone # (978) 215-2400

Banks or Depositories

Bank of America
PO Box 27025
Richmond, Virginia 23261

Signed: Ben Mallen
Date Signed: 12/12/2018

(End FEC FORM 1)

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