FEC Form 1 for American Insurance Association Political Action CommitteeForm 1 for American Insurance Association Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-408453

1. American Insurance Association Political Action Committee

2101 L Street, NW
Suite 400
Washington, DC 20037

NOTE: Address is different than previously reported

Email: lpusey@aiadc.org

2. Date: 03/19/2009

3. FEC Committee ID #: C00103143 This committee is a separate segregated fund. Its connected organization is a Trade Association
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Committee ID# C00103143
American Insurance Association
2101 L Street, NW
Suite 400
Washington, DC 20037
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Tamera Velasquez
2101 L Street, NW
Suite 400
Washington, DC 20037
Title: Assistant Treasurer
Phone # (202) 828-7100

Treasurer:

Leigh Ann Pusey
2101 L Street, NW
Suite 400
Washington, DC 20037
Title: Treasurer
Phone # (202) 828-7100

Designated Agent(s):

Tamera Velasquez
2101 L Street, NW
Suite 400
Washington, DC 20037
Title: Assistant Treasurer
Phone # (202) 828-7100

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-408453

1. American Insurance Association Political Action Committee

NOTE: Address is different than previously reported

2. Date: 03/19/2009

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Mrs. Leigh Ann Pusey
Date Signed: 03/19/2009

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-408453

1. American Insurance Association Political Action Committee

NOTE: Address is different than previously reported

2. Date: 03/19/2009

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Mrs. Leigh Ann Pusey Date Signed: 03/19/2009

(End FEC FORM 1)

Signed: Mrs. Leigh Ann Pusey
Date Signed: 03/19/2009