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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-914129

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1. Broadcom Corporation PAC

    5300 California Avenue
    Irvine, CA 92617
    Email: deannw@broadcom.com

2. Date: 03/28/2014

3. FEC Committee ID #: C00477919 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Broadcom Corporation
5300 California Ave
Irvine, California 92617
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Maria Wronski
5300 California Avenue
Irvine, CA 92617
Title: Treasurer

Treasurer:

Thomas Peter Andrew
5300 California Avenue
Irvine, California 92617
Title: Treasurer

Designated Agent(s):

Robert Tirva
5300 California Ave
Irvine, California 92617
Title: Assistant Treasurer

Banks or Depositories

Bank of America
1655 Grant St
Building A, 10th Floor
Concord, California 945202445

Signed: Thomas Peter Andrew
Date Signed: 03/28/2014

FORM TEXT

(End FEC FORM 1)

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