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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-43831

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1. Unity Mutual Life Insurance Company PAC

    P.O. Box 5000
    Syracuse, NY 132505000
    Email: emerante@unity-life.com jkopcik@unity-life.com

2. Date: 07/16/2002

3. FEC Committee ID #: C00331348 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Unity Mutual Life Insurance Company
P.O. Box 5000
Syracuse, New York 132505000
Organization Type: Corporation W/O Capital Stock

Custodian of Records:

Ms Ellen Merante
P.O. Box 5000
Syracuse, NY 13250
Title: Custodian of Records
Phone # (315) 448-7220

Treasurer:

Mrs. Joyce Kopcik
P.O. Box 5000
Syracuse, New York 13250
Title: Treasurer
Phone # (315) 448-7106

Designated Agent(s):

Ms Ellen Merante
P.O. Box 5000
Syracuse, New York 13250
Title: Assistant Treasurer
Phone # (315) 448-7220

Banks or Depositories

Chase Manhattan Bank
One Lincoln Center
Syracuse, New York 13202

Signed: Mrs. Joyce Kopcik
Date Signed: 07/16/2002

(End FEC FORM 1)

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