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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-835685

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1. FARMERS GROUP, INC. POLITICAL ACTION COMMITTEE

    2350 KERNER BLVD., SUITE 250
    SAN RAFAEL, CA 94901
    Email: sscally@nmgovlaw.com

2. Date: 11/30/2012

3. FEC Committee ID #: C00135681 This committee is a separate segregated fund. Its connected organization is a Corporation
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

FARMERS GROUP, INC.
4680 WILSHIRE BLVD.
LOS ANGELES, California 90010
Affiliated Relationship Code: Connected Organization

ZURICH HOLDING COMPANY OF AMERICAN COM
1201 F ST., NW
WASHINGTON, DC 20004
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

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

Treasurer:

VIGO G. NIELSEN, JR.
2350 KERNER BLVD., SUITE 250
SAN RAFAEL, California 94901
Title: Treasurer
Phone # (415) 389-6800

Designated Agent(s):

DARRIN LIM
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: Vigo G. Nielsen, Jr.
Date Signed: 11/29/2012

(End FEC FORM 1)

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