FEC Form 1 for UNIVERSAL AMERICAN FINANCIAL CORP PACForm 1 for UNIVERSAL AMERICAN FINANCIAL CORP PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-289914

1. UNIVERSAL AMERICAN FINANCIAL CORP PAC

6 INTERNATIONAL DRIVE SUITE 190
RYE BROOK, NY 10573
Fax: 9149340700
Email: uafcpac@uafc.com

2. Date: 05/31/2007

3. FEC Committee ID #: C00433029 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Universal American Financial Corp.
6 International Drive
Suite 190
Rye Brook, New York 10573
Relationship: Connected Org.
Organization Type: Corporation

Custodian of Records:

James P. McAleer
Universal American
6 International Drive Suite 190
Rye Brook, NY 10573
Title: Treasurer
Phone # (914) 934-5200

Treasurer:

James P. McAleer
Universal American
6 International Drive Suite 190
Rye Brook, New York 10573
Title: Treasurer
Phone # (914) 934-5200

Designated Agent(s):

Gary Jacobs
Universal American
3050 Universal Blvd. Suite 150
Weston, Florida 33331
Title: Assistant Treasurer
Phone # (954) 888-4910

Banks or Depositories

Bank of America
600 Peachtree Street
9th Floor
Atlanta, Georgia 303082265

Signed: James P. McAleer
Date Signed: 05/31/2007
Official Committee FAX: 9149340700

(End FEC FORM 1)

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