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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-133854

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1. Aetna Inc. Political Action Committee

    151 Farmington Ave.
    RW61
    Hartford, CT 06156

    NOTE: Address is different than previously reported

    Fax: 8602734479
    Email: PreisnerTL@aetna.com

2. Date: 09/07/2004

3. FEC Committee ID #: C00181826 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Jonathan Topodas
1331 F Street NW
Suite 450
Washington, DC 20004
Title: Treasurer
Phone # (202) 419-7042

Designated Agent(s):

Tammy Preisner
151 Farmington Ave.
RW61
Hartford, Connecticut 06156
Title: Asst. Treasurer
Phone # (860) 273-5670

Banks or Depositories

Fleet Bank
777 Main Street
Hartford, Connecticut 06156

Signed: Jonathan Topodas
Date Signed: 09/07/2004
Official Committee FAX: 8602734479

(End FEC FORM 1)

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