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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-440864

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1. FINANCIAL SERVICES INSTITUTE PAC

    900 CIRCLE 75 PKWY SUITE 860
    ATLANTA, GA 30339
    Email: dale.brown@financialservices.org

2. Date: 11/24/2009

3. FEC Committee ID #: C00409714 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Dale E Brown
900 Circle 75 Parkway
Suite 860
Atlanta, GA 30339
Title: President & CEO
Phone # (770) 980-8487

Treasurer:

Dale E Brown
900 Circle 75 Parkway
Suite 860
Atlanta, Georgia 30339
Title: President & CEO
Phone # (770) 980-8487

Designated Agent(s):

Banks or Depositories

Signed: Dale E Brown
Date Signed: 11/24/2009

(End FEC FORM 1)

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