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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1057606

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1. Chubb Group Holdings Inc. Legacy Political Action Committee

    NOTE:Commmittee Name is different than previously reported

    15 Mountain View Road
    Warren, NJ 07059
    Email: snarron@chubb.com

2. Date: 03/29/2016

3. FEC Committee ID #: C00229203 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

Chubb Group Holdings Inc.
436 Walnut Street
WAO4P
Philadelphia, Pennsylvania 19106
Affiliated Relationship Code: Connected Organization

Chubb Group Holdings Inc. Political Ac
436 Walnut Street
WAO4P
Philadelphia, Pennsylvania 19106
Affiliated Relationship Code: Affiliated Committee

Rain and Hail Insurance Society Politi
9200 Northpark Drive
Suite 300
Johnston, Iowa 50131
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Treasurer:

Thomas J. Ganter
15 Mountain View Road
Warren, New Jersey 07059
Title: Treasurer
Phone # (908) 903-2340

Designated Agent(s):

Sima Narron
901 F Street, NW
Suite 550
Washington, DC 20004
Title: Assistant Treasurer
Phone # (202) 772-1318

Banks or Depositories

Peapack-Gladstone Bank
PO box 178
Gladstone, New Jersey 07934

Signed: Thomas J. Ganter
Date Signed: 03/29/2016

FORM TEXT-1

(End FEC FORM 1)

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