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There are TWO(2) EMD Serono PAC contribution options:

• PAC Leaders Club Members receive invitations to participate in exclusive events with Members of Congress including the annual PAC Leaders Club Conference in Washington, D.C. PAC Leaders Club contributions are made via payroll deduction with suggested contribution guidelines based on your HR Role Level.

• PAC Supporters receive periodic PAC updates and newsletters while supporting the mission of the PAC. Contributions at this level can be made via one-time or monthly payroll deductions or via secure credit card. Supporters can contribute any amount.

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Join the PAC Leaders Club Join as a PAC Supporter

JOIN THE PAC LEADERS CLUB TO JOIN THE PAC LEADERS CLUB

Role 6 & Above: $5,000 annually

Roles 4&5: 1% of base salary

Roles 2&3: ½ of 1% of base salary

JOIN AS A SUPPORTER TO JOIN As a Supporter

Contribute via Credit Card Contribute via Payroll Deduction

$1,000 $500 $250 $100 Other

* * Card Number:

* * Billing First Name:

* * Billing Last Name:

* * Billing Zip:

* Card Expiration Date

Month:

Year

CVV

Monthly Recurring Donation

Your credit card will be charged $#### monthly

Contributor Information

* * First Name:

* * Last Name:

* * Street 1:

Street 2:

* * City:

* * State:

* * Zip:

Home Phone:

Work Phone:

* * Work Email:

* * Employer:

* * Occupation:

* * MUID:

Please specify your Business Unit/Therapeutic Area:

In accordance with Federal Election Commission law, individuals may not give more than $5,000/year to a political action committee. Contributions to EMD Serono PAC are not deductible as charitable contributions for federal income tax purposes. All contributions to the EMD Serono PAC are completely voluntary and will be used for political purposes. You have the right to refuse to contribute without reprisal. The suggested contribution guidelines are suggestions only. EMD Serono will not favor or disadvantage you based on whether you give more or less or not at all. Contributions may only be made from citizens or resident aliens (“Green Card” holder) of the United States. Federal law requires that EMD Serono PAC use its best efforts to collect and report the name, mailing address, occupation and name of employer of individuals whose contributions exceed $200 in a calendar year.

© 2022 EMD Serono, Inc.

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