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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-119319

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1. Assurant Inc. Political Action Committee

    501 W. Michigan St.
    Milwaukee, WI 53203

2. Date: 05/11/2004

3. FEC Committee ID #: C00185694 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Assurant Inc.
1 Chase Manhattan Plaza
New York, New York 10005
Relationship: Connected Organization
Organization Type: Corporation

Custodian of Records:

Steve Swanson
501 West Michigan
Milwaukee, WI 53203
Title: Treasurer
Phone # (414) 299-6798

Treasurer:

Steve Swanson
501 West Michigan
Milwaukee, Wisconsin 53203
Title: Treasurer
Phone # (414) 299-6798

Designated Agent(s):

Renee Scherck-Meyer
501 West Michigan
Milwaukee, Wisconsin 53203
Title: Assistant Treasurer
Phone # (414) 299-7678

Banks or Depositories

U.S. Bank
777 E. Wisconsin Avenue
Milwaukee, Wisconsin 53201

Signed: Steve Swanson
Date Signed: 05/11/2004

(End FEC FORM 1)

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