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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1165600

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1. Masimo Corporation Political Action Committee

    Forty Parker
    Irvine, CA 92618
    Email: mrgriffin@comerica.com

    NOTE: Email address is different than previously reported

2. Date: 02/10/2014

3. FEC Committee ID #: C00493940 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Masimo Corporation
Forty Parker
Irvine, California 92618
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Comerica Bank
PAC Services, MC2250
P.O. Box 75000
Detroit, MI 48275
Title: Recordkeeper
Phone # (248) 371-6515

Treasurer:

Elaine Shamir
P.O. Box 75000
MC2250
Detroit, Michigan 48275
Title: PAC Treasurer
Phone # (248) 371-6515

Designated Agent(s):

Banks or Depositories

Comerica Bank
P.O. Box 75000
Detroit, Michigan 48275

Signed: Elaine Shamir
Date Signed: 02/10/2014

FORM TEXT-1

(End FEC FORM 1)

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