FEC Form 1 for Liberty Mutual Insurance Company-PACForm 1 for Liberty Mutual Insurance Company-PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-31994

1. Liberty Mutual Insurance Company-PAC

175 Berkeley Steet
Boston, MA 02117

2. Date: 10/27/1983

3. FEC Committee ID #: C00171843 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Wausau Insurance Companies
P. O. Box 8017
Wausau, Wisconsin 54402
Relationship: Affiliated Committees

Liberty Mutual Insurance Company
175 Berkeley Street
Boston, Massachusetts 02117
Relationship: Connected Organizations
Organization Type: Corporation

Custodian of Records:

Paul Mattera
175 Berkeley Street
Boston, MA 02117
Title: Secretary
Phone # (617) 574-5679

Treasurer:

Judith Arnost
175 Berkeley Steet
Boston, Massachusetts 02117
Title: Treasurer
Phone # (617) 357-9500

Designated Agent(s):

Richard Cloran
175 Berkeley Street
Boston, Massachusetts 02117
Title: Assistant Treasurer
Phone # (617) 357-9500

Banks or Depositories

Fleet Bank
100 Federal Street
Boston, Massachusetts 02110

Signed: Judith M Arnost
Date Signed: 04/11/2002

(End FEC FORM 1)

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