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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1002710

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1. Commonwealth-Altadis, Inc. Employee PAC

    5900 N Andrews Ave
    Suite 1100
    Fort Lauderdale, FL 33309
    Email: john.ostronic@us.imptob.com

2. Date: 04/14/2015

3. FEC Committee ID #: C00455600 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Commonwealth - Altadis, Inc.
5900 N. Andrews Avenue
Ft. Lauderdale, Florida 33309
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

John Ostronic
5900 N Andrews Ave
Suite 1100
Fort Lauderdale, fL 33309
Title: Director, Government
Phone # (954) 772-9000

Designated Agent(s):

Clay Griffin
301 N. Scales Street
Reidsville, North Carolina 27320
Title: Regulatory Affairs M
Phone # (336) 634-4218

Banks or Depositories

Wells Fargo Bank
6400 N Andrews Avenue
Suite 100
Fort Lauderdale, Florida 33309

Signed: John Ostronic
Date Signed: 04/14/2015

FORM TEXT-1

(End FEC FORM 1)

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