FEC Form 1 for King Pharmaceuticals, Inc. Political Action CommitteeForm 1 for King Pharmaceuticals, Inc. Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-716635

1. King Pharmaceuticals, Inc. Political Action Committee

501 Fifth Street
Bristol, TN 37620
Email: KingPAC@kingpharm.com

2. Date: 03/10/2011

3. FEC Committee ID #: C00467829 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

King Pharmaceuticals, Inc.
501 Fifth Street
Bristol, Tennessee 37620
Affiliated Relationship Code: Connected Organization

Pfizer Inc. PAC
235 East 42nd Street
New York, New York 10017
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Frederick Brouillette, Jr.
501 Fifth Street
Bristol, TN 37620
Title: Treasurer
Phone # (423) 989-8751

Treasurer:

Frederick Brouillette, Jr.
501 5th Street
Bristol, Tennessee 37620
Title: Treasurer
Phone # (423) 989-8751

Designated Agent(s):

Brett A. Burrell
501 Fifth Street
Bristol, Tennessee 37620
Title: Assistant Treasurer
Phone # (423) 989-8712

Banks or Depositories

Bank of America
1143 Volunteer Parkway
Bristol, Tennessee 37620

Signed: Frederick Brouillette, Jr.
Date Signed: 03/09/2011

(End FEC FORM 1)

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