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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-973294

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1. Varian Medical Systems, Inc. PAC ('Varian PAC')

    801 Pennsylvania Avenue, NW
    Suite 730
    Washington, DC 20004

    NOTE: Address is different than previously reported

    Email: varianpac@varian.com

2. Date: 11/20/2014

3. FEC Committee ID #: C00450965 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

Varian Medical Systems, Inc.
3100 Hansen Way
Palo Alto, California 94304
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Maureen Zilly Tracy
801 Pennsylvania Avenue, NW
Suite 730
Washington, DC 20004
Title: Treasurer
Phone # (202) 629-3441

Treasurer:

Maureen Zilly Tracy
801 Pennsylvania Avenue, NW
Suite 730
Washington, DC 20004
Title: Treasurer
Phone # (202) 629-3441

Designated Agent(s):

Franco Palomba
3100 Hansen Way
Palo Alto, California 94304
Title: Assistant Treasurer
Phone # (650) 424-5955

Banks or Depositories

Bank of America
1001 Pennsylvania Ave NW
Washington, DC 20004

Signed: Maureen Zilly Tracy
Date Signed: 11/20/2014

FORM TEXT

(End FEC FORM 1)

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