FEC Form 1 for Assurant Inc. Political Action CommitteeForm 1 for Assurant Inc. Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-409620

1. Assurant Inc. Political Action Committee

501 West Michigan Street
Milwaukee, WI 53203
Email: Steve.Swanson@assurant.com

2. Date: 03/26/2009

3. FEC Committee ID #: C00185694 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

Committee ID# C00185694
Assurant Inc.
1 Chase Manhattan Plaza
New York, New York 10005
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Steve Swanson
501 West Michigan Street
Milwaukee, WI 53203
Title: Treasurer
Phone # (414) 299-6798

Treasurer:

Steve Swanson
501 West Michigan St
Milwaukee, Wisconsin 53203
Title: Treasurer
Phone # (414) 299-6798

Designated Agent(s):

Bill Kobusch
501 West Michigan Street
Milwaukee, Wisconsin 53203
Title: Assistant Treasurer
Phone # (414) 299-6863

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-409620

1. Assurant Inc. Political Action Committee

2. Date: 03/26/2009

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Mr. Steve Swanson
Date Signed: 03/26/2009

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-409620

1. Assurant Inc. Political Action Committee

2. Date: 03/26/2009

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Mr. Steve Swanson Date Signed: 03/26/2009

(End FEC FORM 1)

Signed: Mr. Steve Swanson
Date Signed: 03/26/2009