FEC Form 1 for Property Casualty Insurers Association of America Political Action Committee (PCIPAC)Form 1 for Property Casualty Insurers Association of America Political Action Committee (PCIPAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-103772

1. Property Casualty Insurers Association of America Political Action Committee (PCIPAC)

NOTE:Commmittee Name is different than previously reported

2600 South River Road
Des Plaines, IL 600183286
Fax: 847-297-5064

2. Date: 01/08/2004

3. FEC Committee ID #: C00066472 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Property Casualty Insurers Association of America
2600 South River Road
Des Plaines, Illinois 600183286
Relationship: Connected Organization
Organization Type: Trade Association

Alliance of American Insurers Politica
3025 Highland Parkway
Suite 800
Downers Grove, Illinois 60515
Relationship: Affiliated Committee

Custodian of Records:

Linda Dugas
2600 South River Road
Des Plaines, IL 600183286
Title: Senior Accountant
Phone # (847) 297-7800

Treasurer:

June Holmes
2600 South River Road
Des Plaines, Illinois 600183286
Title: Treasurer
Phone # (847) 297-7800

Designated Agent(s):

Banks or Depositories

USbank
9575 West Higgins Road
Rosemont, Illinois 60018

Signed: June Holmes
Date Signed: 01/15/2004
Official Committee URL: pciaa.net
Official Committee FAX: 847-297-5064

(End FEC FORM 1)

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