FEC Form 1 for Delphi Corporation Political Action CommitteeForm 1 for Delphi Corporation Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-437662

1. Delphi Corporation Political Action Committee

1301 Pennsylvania Avenue, NW
Suite 1020
Washington, DC 20004

NOTE: Address is different than previously reported

Email: john.t.anderson@delphi.com

NOTE: Email address is different than previously reported

2. Date: 10/21/2009

3. FEC Committee ID #: C00346130 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Delphi Corporation
5725 Delphi Drive
M/C 483-400-521
Troy, Michigan 480982815
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Comerica Bank PAC Services
P.O. Box 75000
MC 2250
Detroit, MI 482752250
Title: Recordkeeper
Phone # (248) 371-7045

Treasurer:

Ronald S. Siemiontkowski
Comerica Bank PAC Services MC2250
P.O. Box 75000
Detroit, Michigan 482752250
Title: Treasurer
Phone # (248) 371-7045

Designated Agent(s):

John Anderson
1301 Pennsylvania Avenue, NW
Suite 1020
Washington, DC 20004
Title: Chairman
Phone # (202) 824-0401

Banks or Depositories

Comerica Bank
P.O. Box 75000
PAC Services MC 2250
Detroit, Michigan 482752250

Signed: Ronald S. Siemiontkowski
Date Signed: 10/21/2009

(End FEC FORM 1)

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