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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1362625

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1. JUUL Labs Employees Political Action Committee (JLE PAC)

    1000 F Street, NW
    8th Floor
    Washington, DC 20004

    NOTE: Address is different than previously reported

    Email: jlepac@juul.com;brandy.stacks@juul.com

    NOTE: Email address is different than previously reported

2. Date: 11/14/2019

3. FEC Committee ID #: C00674242 This committee is a separate segregated fund. Its connected organization is a Corporation
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

JUUL Labs, Inc.
560 20TH ST
San Francisco, California 941074344
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Brandy Stacks
1000 F Street, NW
8th Floor
Washington, DC 20004
Title: Custodian of Records

Treasurer:

James P. Scholtes
1000 F Street, NW
8th Floor
Washington, DC 20004
Title: Treasurer

Designated Agent(s):

Jennifer Olson
1000 F Street, NW
8th Floor
Washington, DC 20004
Title: Assistant Treasurer

Banks or Depositories

Union Bank
350 California St.
San Francisco, California 94104

Signed: James P. Scholtes
Date Signed: 11/14/2019

(End FEC FORM 1)

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