Generated On: 9/6/2018 1:15:03 PM Verified Statement Registration VSR (Out-of-State Committee) 8518 Express Scripts Inc. Political Fund 300 New Jersey Avenue, NWSuite 600 Washington, DC 20001 202-383-7989 [email protected] Other PAC Contact Last Name: Houts First Name: Jonah MI: C Address: 300 New Jersey Avenue, NW Suite 600 City: Washington State: DC Zip Code: 20001 Phone: 202-383-7989 E-Mail: [email protected] Parent Entity Name: Express Scripts, Inc. Address: One Express Way City: St. Louis State: MO Zip Code: 63121 Phone: 952-837-5103 E-Mail: Jurisdiction Name: Federal Election Commission Address: 999 E Street, NW City: Washington State: DC Zip Code: 20463 Phone: 202-694-1100 E-Mail: Iowa Resident Agent Last Name: Triplett First Name: Michael MI: Address: 855 E. Court Avenue City: Des Moines State: IA Zip Code: 50309 Phone: 515-707-3464 E-Mail: 2018 - Iowa Committees Receiving Contributions Contribution Date Committee Amount Check # 8/30/2018 Fry for Iowa House (1849) $250.00 3425 Filed Date: 1473 195th Ave. 9/6/2018 Osceola, IA 50213 IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 1 of 10 Generated On: 9/6/2018 1:15:03 PM 2018 - Iowa Committees Receiving Contributions Contribution Date Committee Amount Check # 8/30/2018 Mark Smith for Iowa House (1247) $250.00 3435 Filed Date: 816 Roberts Terrace 9/6/2018 Marshalltown, IA 50158- 8/30/2018 Tom Shipley for Iowa (2196) $250.00 3423 Filed Date: 2425 Birch Ave. 9/6/2018 Nodaway, IA 50857 8/30/2018 Costello for Iowa Senate (2014) $500.00 3416 Filed Date: 37265 Rains Ave 9/6/2018 Imogene, IA 51645 8/30/2018 Kim Reynolds for Iowa (5173) $1,000.00 3433 Filed Date: 1010 A Park Lane 9/6/2018 Osceola, IA 50213 8/30/2018 Johnson for Iowa (2159) $250.00 3431 Filed Date: 413 13th Avenue NE 9/6/2018 Independence, IA 50644 8/30/2018 Friends For Breitbach (1838) $250.00 3432 Filed Date: 301 W. Mission St. 9/6/2018 Strawberry Point, IA 52076 8/30/2018 Amanda Ragan for Iowa Senate (1336) $250.00 3422 Filed Date: 361 S. Penn. 1D 9/6/2018 Mason City, IA 50401 8/30/2018 Friends of Whitver (1953) $500.00 3429 Filed Date: 4019 NE Bellagio Circle 9/6/2018 Ankeny, IA 50021 8/30/2018 Bergan for Iowa House (2382) $250.00 3426 Filed Date: 1204 N Bear Rd 9/6/2018 Dorchester, IA 52140 8/30/2018 Mathis for State Senate (1979) $250.00 3421 Filed Date: 320 Blairs Ferry Crossing 9/6/2018 Hiawtha, IA 52233 8/30/2018 Lundgren for House (2294) $500.00 3417 Filed Date: 916 HEATHER DR 9/6/2018 PEOSTA, IA 52068 8/30/2018 Upmeyer for House (1400) $500.00 3430 Filed Date: 1811 N. 8th St. 9/6/2018 Clear Lake, IA 50428 8/30/2018 Hagenow for Iowa House (1737) $500.00 3434 Filed Date: 15115 Prairie Avenue 9/6/2018 Urbandale, IA 50323 8/30/2018 Chapman For Senate (1961) $250.00 3419 Filed Date: 25862 Fox Ridge Ln 9/6/2018 Adel, IA 50003 8/30/2018 Schneider for State Senate (2107) $500.00 3428 Filed Date: 7887 Cody Drive 9/6/2018 West Des Moines, IA 50266 IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 2 of 10 Generated On: 9/6/2018 1:15:03 PM 2018 - Iowa Committees Receiving Contributions Contribution Date Committee Amount Check # 8/30/2018 Mark Segebart for Senate (2056) $250.00 3415 Filed Date: 1820 350th Street 9/6/2018 Vail, IA 51465 8/30/2018 Brian Best for House (2139) $250.00 3424 Filed Date: 600 Vermont St. Box 491 9/6/2018 Glidden, IA 51443 8/30/2018 Friends for Zach Nunn (2151) $250.00 3418 Filed Date: PO Box 105 9/6/2018 Altoona, IA 50009 IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 3 of 10 Generated On: 9/6/2018 1:15:03 PM 2017 - Iowa Committees Receiving Contributions Contribution Date Committee Amount Check # 8/31/2017 Rizer for House (2114) $250.00 2991 Filed Date: 2535 Prairie Hill Drive #12 8/28/2017 Marion, IA 52302 8/31/2017 Mathis for State Senate (1979) $250.00 2995 Filed Date: 320 Blairs Ferry Crossing 8/28/2017 Hiawtha, IA 52233 8/31/2017 Friends For Breitbach (1838) $250.00 2996 Filed Date: 301 W. Mission St. 8/28/2017 Strawberry Point, IA 52076 8/31/2017 Friends of Whitver (1953) $500.00 2998 Filed Date: 4019 NE Bellagio Circle 8/28/2017 Ankeny, IA 50021 8/31/2017 Friends for Zach Nunn (2151) $250.00 2988 Filed Date: PO Box 105 8/28/2017 Altoona, IA 50009 8/31/2017 Friends for Dix (1846) $500.00 2999 Filed Date: 317 S Walnut 8/28/2017 Shell Rock, IA 50670 8/31/2017 Upmeyer for House (1400) $500.00 2994 Filed Date: 1811 N. 8th St. 8/28/2017 Clear Lake, IA 50428 8/31/2017 Kim Reynolds for Iowa (5173) $1,000.00 3001 Filed Date: 1010 A Park Lane 8/28/2017 Osceola, IA 50213 8/31/2017 Fry for Iowa House (1849) $250.00 2990 Filed Date: 1473 195th Ave. 8/28/2017 Osceola, IA 50213 8/31/2017 Mark Smith for Iowa House (1247) $250.00 2992 Filed Date: 816 Roberts Terrace 8/28/2017 Marshalltown, IA 50158- 8/31/2017 Lundgren for House (2294) $250.00 2989 Filed Date: 916 HEATHER DR 8/28/2017 PEOSTA, IA 52068 8/31/2017 Citizens for Rob Hogg (1347) $250.00 2997 Filed Date: 2750 Otis Road SE 8/28/2017 Cedar Rapids, IA 52403 8/31/2017 Hagenow for Iowa House (1737) $500.00 2993 Filed Date: 15115 Prairie Avenue 8/28/2017 Urbandale, IA 50323 IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 4 of 10 Generated On: 9/6/2018 1:15:03 PM 2016 - Iowa Committees Receiving Contributions Contribution Date Committee Amount Check # 9/15/2016 Committee to Elect Gary Carlson (2133) $250.00 2714 Filed Date: 104 Deerpath Lane 9/15/2016 Muscatine, IA 52761 9/15/2016 Iowans For Prichard (2109) $250.00 2721 Filed Date: 107 Ferguson St 9/15/2016 Iowa, IA 50616 9/15/2016 Citizens for Gronstal (1612) $500.00 2720 Filed Date: 220 Bennett Ave. 9/15/2016 Council Bluffs, IA 51503 9/15/2016 Rizer for House (2114) $250.00 2716 Filed Date: 2535 Prairie Hill Drive #12 9/15/2016 Marion, IA 52302 9/15/2016 Mark Smith for Iowa House (1247) $250.00 2717 Filed Date: 816 Roberts Terrace 9/15/2016 Marshalltown, IA 50158- 9/15/2016 Hagenow for Iowa House (1737) $500.00 2718 Filed Date: 15115 Prairie Avenue 9/15/2016 Urbandale, IA 50323 9/15/2016 Upmeyer for House (1400) $500.00 2713 Filed Date: 1811 N. 8th St. 9/15/2016 Clear Lake, IA 50428 9/15/2016 Friends for Dix (1846) $500.00 2716 Filed Date: 317 S Walnut 9/15/2016 Shell Rock, IA 50670 IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 5 of 10 Generated On: 9/6/2018 1:15:03 PM 2015 - Iowa Committees Receiving Contributions Contribution Date Committee Amount Check # 12/3/2015 Friends of Whitver (1953) $200.00 2522 Filed Date: 4019 NE Bellagio Circle 12/3/2015 Ankeny, IA 50021 12/3/2015 Hagenow for Iowa House (1737) $450.00 2524 Filed Date: 15115 Prairie Avenue 1/19/2016 Urbandale, IA 50323 12/3/2015 Citizens for Gronstal (1612) $450.00 2520 Filed Date: 220 Bennett Ave. 12/3/2015 Council Bluffs, IA 51503 12/3/2015 Upmeyer for House (1400) $450.00 2518 Filed Date: 1811 N. 8th St. 12/3/2015 Clear Lake, IA 50428 12/3/2015 Mathis for State Senate (1979) $200.00 2521 Filed Date: 320 Blairs Ferry Crossing 12/3/2015 Hiawtha, IA 52233 12/3/2015 Iowans For Prichard (2109) $200.00 2525 Filed Date: 107 Ferguson St 1/19/2016 Iowa, IA 50616 12/3/2015 Friends for Dix (1846) $450.00 2527 Filed Date: 317 S Walnut 1/19/2016 Shell Rock, IA 50670 12/3/2015 Friends of Rob Bacon (1842) $200.00 2519 Filed Date: 104 N. Tama St PO Box 485 12/3/2015 Slater, IA 50244 12/3/2015 Committee to Elect Gary Carlson (2133) $200.00 2526 Filed Date: 104 Deerpath Lane 1/19/2016 Muscatine, IA 52761 12/3/2015 Mark Smith for Iowa House (1247) $200.00 2523 Filed Date: 816 Roberts Terrace 12/3/2015 Marshalltown, IA 50158- IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 6 of 10 Generated On: 9/6/2018 1:15:03 PM 2013 - Iowa Committees Receiving Contributions Contribution Date Committee Amount Check # 9/5/2013 Mark Smith for Iowa House (1247) $300.00 2003 Filed Date: 816 Roberts Terrace 9/18/2013 Marshalltown, IA 50158- 8/5/2013 Amanda Ragan for Iowa Senate (1336) $200.00 1984 Filed Date: 361 S. Penn. 1D 8/9/2013 Mason City, IA 50401 8/5/2013 Cownie for Statehouse (1711) $200.00 1988 Filed Date: 4109 Timberwood Drive 8/9/2013 West Des Moines, IA 50265 8/5/2013 Iowans for Taylor (1968) $200.00 1990 Filed Date: PO Box 337 8/9/2013 Waukee, IA 50263 8/5/2013 Citizens for Gronstal (1612) $300.00 1991 Filed Date: 220 Bennett Ave.