FEC Form 1 for QWEST COMMUNICATIONS INTERNATIONAL INC POLITICAL ACTION COMMITTEEForm 1 for QWEST COMMUNICATIONS INTERNATIONAL INC POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-105234

1. QWEST COMMUNICATIONS INTERNATIONAL INC POLITICAL ACTION COMMITTEE

607 14th Street N.W.
Suite 950
Washington, DC 20005
Fax: 2024674268
Email: qwestpac@qwest.com

2. Date: 01/28/2004

3. FEC Committee ID #: C00237156 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Qwest Communications International Inc.
1801 California Street
Denver, Colorado 80202
Relationship: Connected
Organization Type: Corporation

Custodian of Records:

Cynthia Sager
1020 19th Street NW
Suite 700
Washington, DC 20036
Title: Custodian
Phone # (202) 429-3101

Treasurer:

Michael Rubin
1020 19th Street NW
Suite 700
Washington, DC 20036
Title: Treasurer

Designated Agent(s):

Jeff Wirtzfeld
1801 California Street
Denver, Colorado 80202
Title: Assistant Treasurer
Phone # (303) 896-0032

Cynthia Sager
1020 19th Street
Suite 700
Washington, DC 20036
Title: Assistant Treasurer
Phone # (202) 429-3101

Banks or Depositories

Wells Fargo Bank N.A.
1740 BROADWAY STREET
DENVER, Colorado 80274

Signed: Cynthia Sager
Date Signed: 01/28/2004
Official Committee URL: http://qwestpac.uswc.uswest.com/federal/qwestpac.nsf
Official Committee FAX: 2024674268

(End FEC FORM 1)

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