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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1484745

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1. BLOOM ENERGY PAC

    4353 NORTH FIRST STREET
    SAN JOSE, CA 95134
    Email: FECFORM1@NMGOVLAW.COM

2. Date: 11/24/2020

3. FEC Committee ID #: C00764290 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

BLOOM ENERGY
4353 NORTH FIRST STREET
SAN JOSE, California 95134
Affiliated Relationship Code: Connected Organization

Custodian of Records:

ELLI ABDOLI
2350 KERNER BLVD., SUITE 250
SAN RAFAEL, CA 94901
Title: Custodian of Records
Phone # (415) 389-6800

Treasurer:

ELLI ABDOLI
2350 KERNER BLVD., SUITE 250
SAN RAFAEL, California 94901
Title: Treasurer
Phone # (415) 389-6800

Designated Agent(s):

JOEL S. AURORA
2350 KERNER BLVD., SUITE 250
SAN RAFAEL, California 94901
Title: Assistant Treasurer
Phone # (415) 389-6800

Banks or Depositories

BANK OF MARIN
504 TAMALPAIS DRIVE
CORTE MADERA, California 94925

Signed: ELLI ABDOLI
Date Signed: 11/24/2020

(End FEC FORM 1)

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