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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-731361

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1. MOS Holdings Inc. Political Action Committee (Mosaic PAC)

    NOTE:Commmittee Name is different than previously reported

    3033 Campus Drive
    Suite E490
    Plymouth, MN 55441
    Email: PAC@mosaicco.com

2. Date: 06/15/2011

3. FEC Committee ID #: C00455766 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

MOS Holdings Inc.
3033 Campus Drive Suite E490
Plymouth, Minnesota 55441
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Kenneth Bodell
3033 Camous Drive
Suite E490
Plymouth, MN 55441

Treasurer:

Kenneth Bodell
3033 Camous Drive
Suite E490
Plymouth, Minnesota 55441

Designated Agent(s):

Banks or Depositories

Associated Bank
2655 Campus Drive
Plymouth, Minnesota 55441

Signed: Kenneth Bodell
Date Signed: 06/15/2011

(End FEC FORM 1)

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