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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-103695

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1. Humana Inc. Political Action Committee

    1776 Eye Steet NW
    Suite 890
    Washington, DC 20006

2. Date: 01/15/2004

3. FEC Committee ID #: C00271007 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Humana Corporation
1776 Eye Steet NW
Suite 890
Washington, DC 20006
Organization Type: Corporation

Custodian of Records:

Mary Rosado
1776 Eye Steet NW
Washington, DC 20006
Title: Dir. of Fed. Affairs
Phone # (202) 467-5821

Treasurer:

Mary Rosado
1776 Eye Steet NW
Washington, DC 20006
Title: Dir. of Fed. Affairs
Phone # (202) 467-5821

Designated Agent(s):

Mary Rosado
1776 Eye Steet NW
Washington, DC 20006
Title: Dir. of Fed. Affairs
Phone # (202) 467-5821

Banks or Depositories

National City Bank
Louisville, Kentucky

Signed: Mary Rosado
Date Signed: 01/15/2004

(End FEC FORM 1)

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