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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-286783

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1. AMICA MUTUAL INSURANCE COMPANY/FED-POLITICAL ACTION COMMITTEE

    PO BOX 6008
    PROVIDENCE, RI 02940
    Fax: 4013342270
    Email: mwilliamson@amica.com

2. Date: 04/24/2007

3. FEC Committee ID #: C00268987 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Mary Q. Williamson
P.O. Box 6008
Providence, RI 02940

Treasurer:

Mary Q. Williamson
P.O. Box 6008
Providence, Rhode Island 02940

Designated Agent(s):

Banks or Depositories

Bank of America
P.O. Box 25118
Tampa, Florida 33622

Signed: Mary Q. Williamson
Date Signed: 04/25/2007
Official Committee FAX: 4013342270

(End FEC FORM 1)

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