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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-209655

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1. Hillenbrand Industries Political Action Committee

    1069 State Route 46 East
    Batesville, IN 47006

    NOTE: Address is different than previously reported

2. Date: 12/12/2000

3. FEC Committee ID #: C00363804 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Tom Jeffers
1069 State Route 46 East
Batesville, IN 47006
Title: Treasurer
Phone # (812) 934-7958

Treasurer:

Tom Jeffers
1069 State Route 46 East
Batesville, Indiana 47006-
Title: Treasurer
Phone # (812) 934-7958

Designated Agent(s):

Banks or Depositories

Fifth Third Bank
P.O. Box 630900
Cincinnati, Ohio 45263

Signed: Tom Jeffers
Date Signed: 04/10/2006

(End FEC FORM 1)

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