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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-944213

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1. Herff Jones, Inc. PAC ('Herff Jones PAC')

    4501 W 62nd St.
    Indianapolis, IN 46268
    Email: dshomeier@herffjones.com

    NOTE: Email address is different than previously reported

2. Date: 08/05/2014

3. FEC Committee ID #: C00519009 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Herff Jones, Inc.
4501 W. 62nd St.
Indianapolis, Indiana 46268
Affiliated Relationship Code: Connected Organization

Custodian of Records:

David Homeier
4501 W. 62nd St.
Indianapolis, IN 46268
Title: Custodian of Records
Phone # (317) 748-4608

Treasurer:

David Homeier
4501 W. 62nd St.
Indianapolis, Indiana 46268
Title: Treasurer
Phone # (317) 748-4608

Designated Agent(s):

Adam Hamilton
4501 W 62nd St
Indianapolis, Indiana 46268
Title: Assistant Treasurer
Phone # (317) 612-3477

Banks or Depositories

Old National Bank
900 S. SR135
Greenwood, Indiana 46143

Signed: David Homeier
Date Signed: 08/06/2014

(End FEC FORM 1)

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