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

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-459313


1. Liberty Mutual Insurance Company - PAC

    175 Berkeley Street
    Boston, MA 02117
    Email: kuai.chan@libertymutual.com

2. Date: 03/30/2010

3. FEC Committee ID #: C00171843 This committee is a separate segregated fund. Its connected organization is a Corporation
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Liberty Mutual Insurance Company
175 Berkeley Street
Boston, Massachusetts 02117
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Paul Mattera
175 Berkeley Street
Boston, MA 02117
Title: Custodian of Records

Treasurer:

Laurance Yahia
175 Berkeley Street
Boston, Massachusetts 02117
Title: Treasurer
Phone # (617) 357-9500

Designated Agent(s):

Mark D'Amato
175 Berkeley Street
Boston, Massachusetts 02117
Title: Assistant Treasurer
Phone # (617) 357-9500

Banks or Depositories

Bank of America
100 Federal Street
Boston, Massachusetts 02110

Signed: Laurance Yahia
Date Signed: 04/08/2010

(End FEC FORM 1)


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