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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-128367

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1. NAMIC PAC

    NOTE:Commmittee Name is different than previously reported

    3601 Vincennes Road
    PO Box 68700
    Indianapolis, IN 46268

    NOTE: Address is different than previously reported

    Fax: 317-879-8408
    Email: gdykstra@namic.org

2. Date: 01/29/2002

3. FEC Committee ID #: C00170258 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Gregg A. Dykstra
3601 Vincennes Road
PO Box 68700
Indianapolis, Indiana 46268
Title: Treasurer
Phone # (317) 875-5250

Designated Agent(s):

Banks or Depositories

Signed: Gregg A. Dykstra
Date Signed: 07/19/2004
Official Committee FAX: 317-879-8408

(End FEC FORM 1)

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