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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1033442

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1. Smiths Group Services Corporation Political Action Committee

    425 3rd St SW
    Suite 875
    Washington, DC 20024
    Email: taylor.bannister@smiths.com

    NOTE: Email address is different than previously reported

2. Date: 11/19/2015

3. FEC Committee ID #: C00448324 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

Smiths Group Services Corp
425 3rd St SW
Suite 875
Washington, DC 20024
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Taylor Bannister
425 3rd St SW
Suite 875
Washington, DC 20024
Title: Treasurer
Phone # (202) 777-8447

Treasurer:

Taylor Bannister
425 3rd St SW
Suite 875
Washington, DC 20024
Title: Treasurer
Phone # (202) 777-8447

Designated Agent(s):

Sarah Reigner
425 Third St. SW
Washington, DC 20024
Title: Assistant Treasurer
Phone # (202) 777-8450

Banks or Depositories

Wells Fargo Bank
600 Maryland Ave SW
Washington, DC 20024

Signed: Taylor Bannister
Date Signed: 11/19/2015

(End FEC FORM 1)

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