FEC Form 1 for CONSECO INC CONCERNED CITIZENS POLITICAL ACTION COMMITTEE (PAC)Form 1 for CONSECO INC CONCERNED CITIZENS POLITICAL ACTION COMMITTEE (PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-293400

1. CONSECO INC CONCERNED CITIZENS POLITICAL ACTION COMMITTEE (PAC)

11825 NORTH PENNSYLVANIA
CARMEL, IN 46032
Email: jaydene_shaikhadeh@conseco.com

2. Date: 07/11/2007

3. FEC Committee ID #: C00303503 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

CONSECO
11825 N. PENNSYLVANIA STREET
CARMEL, Indiana 46032
Relationship: CONNECTED ORGANIZATI
Organization Type: Corporation

Custodian of Records:

Treasurer:

WILLIAM D FRITTS, Jr.
535 NORTH COLLEGE DRIVE
CARMEL, Indiana 46032
Title: EVP
Phone # (317) 817-6682

Designated Agent(s):

Banks or Depositories

BANK ONE
7160 W. WASHINGTON STREET
INDIANAPOLIS, Indiana 46231

Signed: WILLIAM D FRITTS, Jr.
Date Signed: 07/11/2007

(End FEC FORM 1)

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