FEC Form 1 for Nationwide Mutual Insurance Company Political Action CommitteeForm 1 for Nationwide Mutual Insurance Company Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-385092

1. Nationwide Mutual Insurance Company Political Action Committee

NOTE:Commmittee Name is different than previously reported

One Nationwide Plaza
1-27-10
Columbus, OH 43215
Fax: 6142493073
Email: bearins@nationwide.com

2. Date: 11/18/2008

3. FEC Committee ID #: C00076174 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Committee ID# C00076174
Nationwide
One Nationwide Plaza
Columbus, Ohio 43215
Affiliated Relationship Code: Connected Organization

Nationwide Mutual Insurance Company Io
1100 Locust
DM-01-0301
Des Moines, Iowa 503910301
Affiliated Relationship Code: Affiliated Committee

Nationwide Mutual Insurance Company an
1601 Exposition Blvd; PC1A
Sacramento, California 95815
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Shannon Bearinger
One Nationwide Plaza
Columbus, OH 43215
Title: Custodian of Records
Phone # (614) 249-5470

Treasurer:

Carol Dove
One Nationwide Plaza
Mail Code 1-32-06
Columbus, Ohio 43215
Title: Treasurer
Phone # (614) 249-6963

Designated Agent(s):

James Benney
One Nationwide Plaza
Mail Code 1-26-05
Columbus, Ohio 43215
Title: AssistantTreasurer
Phone # (614) 249-7811

Banks or Depositories

Huntington National Bank
41 South High Street
HC0810
Columbus, Ohio 43215

Signed: Ms. Carol Dove
Date Signed: 11/18/2008
Official Committee FAX: 6142493073

(End FEC FORM 1)

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