FEC Form 1 for Assurant Inc. Political Action CommitteeForm 1 for Assurant Inc. Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1645203

1. Assurant Inc. Political Action Committee

1101 Pennsylvania Ave, NW
Suite 300
Washington, DC 20004
Email: tom.bolovinos@assurant.com;AssurantPAC@assurant.com

NOTE: Email address is different than previously reported

2. Date: 10/20/2022

3. FEC Committee ID #: C00185694 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

Assurant Inc.
55 Broadway, Suite 2901
New York, New York 10006
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Tom Bolovinos
28 Liberty Street
New York, NY 10005
Title: Treasurer
Phone # (212) 859-7023

Treasurer:

Tom Bolovinos
28 Liberty Street
New York, New York 10005
Title: Treasurer
Phone # (212) 859-7023

Designated Agent(s):

Heidi Star
260 Interstate North Circle, S.E.
Atlanta, Georgia 30339
Title: Assistant Treasurer
Phone # (786) 486-8281

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1645203

1. Assurant Inc. Political Action Committee

NOTE: Email address is different than previously reported

2. Date: 10/20/2022

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Tom Bolovinos
Date Signed: 10/20/2022

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1645203

1. Assurant Inc. Political Action Committee

NOTE: Email address is different than previously reported

2. Date: 10/20/2022

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Tom Bolovinos Date Signed: 10/20/2022

(End FEC FORM 1)

Signed: Tom Bolovinos
Date Signed: 10/20/2022