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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1677325

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1. BROOKDALE SENIOR LIVING PAC

    111 WESTWOOD PLACE SUITE 400
    Brentwood, TN 370275057
    Email: BSLPAC@BROOKDALELIVING.COM;outsourcing@aristotle.com

    NOTE: Email address is different than previously reported

2. Date: 01/10/2023

3. FEC Committee ID #: C00459008 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Brookdale Senior Living Inc.
111 Westwood Place
Suite 400
Brentwood, Tennessee 370275057
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Chadwick C White
111 Westwood Pl
Ste 400
Brentwood, TN 370275057
Title: Custodian of Records
Phone # (615) 221-2250

Treasurer:

Chadwick C White
111 Westwood Pl
Ste 400
Brentwood, Tennessee 370275057
Title: Treasurer
Phone # (615) 221-2250

Designated Agent(s):

Chadwick C White
111 Westwood Pl
Ste 400
Brentwood, Tennessee 370275057
Title: Treasurer
Phone # (615) 221-2250

Banks or Depositories

Bank of America
100 N. Tryon Street
Charlotte, North Carolina 28255

Signed: Chadwick C White
Date Signed: 01/19/2023

FORM TEXT-1

(End FEC FORM 1)

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