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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-14893

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1. American Insurance Association Political Action Committee

    1130 Connecticut Avenue NW
    Suite 1000
    Washington, DC 20036

2. Date: 06/08/2001

3. FEC Committee ID #: C00103143 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

American Insurance Association
1130 Connecticut Avenue NW
Suite 1000
Washington, DC 20036
Relationship: Connected Organizations
Organization Type: Trade Association

Custodian of Records:

Amee Dedrick
1130 Connecticut Avenue
Suite 1000
Washington, DC 20036
Title: PAC Manager

Treasurer:

Leigh Pusey
1130 Connecticut Avenue NW
Suite 1000
Washington, DC 20036
Title: Treasurer

Designated Agent(s):

Amee Dedrick
1130 Connecticut Avenue
Suite 1000
Washington, DC 20036
Title: PAC Manager

Banks or Depositories

First Union Bank N.A.
1100 Connecticut Avenue NW
Washington, DC 20036

Signed: Ms. Leigh Ann Pusey
Date Signed: 06/08/2001

(End FEC FORM 1)

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