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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-23117

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1. United Seniors PAC Inc.

    209 Pennsylvania Avenue SE
    Suite 800
    Washington, DC 20003
    Email: unitedseniorspac@yahoo.com

2. Date: 01/08/2002

3. FEC Committee ID #: C00077354

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

Custodian of Records:

Anita Benjamin
320 Hume Avenue
Alexandria, VA 22301
Title: Executive Director
Phone # (202) 454-5240

Treasurer:

Paul Erickson
209 Pennsylvania Avenue SE
Suite 800
Washington, DC 20003
Title: Treasurer
Phone # (605) 362-8500

Designated Agent(s):

Banks or Depositories

First Virginia Bank
1224 W. Broad Street
Falls Church, Virginia 22046

Signed: Paul Erickson
Date Signed: 01/08/2002

(End FEC FORM 1)

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