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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-433491

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1. Convergys Corporation Political Action Committee

    201 East 4th Street
    Cincinnati, OH 45202
    Email: sarah.k.crispin@convergys.com

2. Date: 09/25/2009

3. FEC Committee ID #: C00350108 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Convergys Corporation
201 East 4th Street
Cincinnati, Ohio 45202

Custodian of Records:

Treasurer:

, ____

Designated Agent(s):

Sarah Crispin
201 East Fourth Street
Cincinnati, Ohio 45202
Title: Director, Government
Phone # (513) 784-2141

Banks or Depositories

US Bank
250 East 5th Street
Cincinnati, Ohio 45202

Signed:
Date Signed: 09/25/2009

FORM TEXT

(End FEC FORM 1)

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