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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-295661

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1. Cozen O'Connor Political Action Committee

    1900 Market Street
    Philadelphia, PA 19103
    Fax: 2158648003
    Email: dellman@cozen.com

2. Date: 07/17/2007

3. FEC Committee ID #: C00312777 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

David W. Ellman
1206 Stongs Lane
Ambler, Pennsylvania 19002
Title: COO
Phone # (215) 665-4655

Designated Agent(s):

Banks or Depositories

Signed: David W. Ellman
Date Signed: 07/17/2007
Official Committee FAX: 2158648003

(End FEC FORM 1)

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