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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-758840

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1. C.V. Starr & Co. Inc. Political Action Committee

    399 Park Avenue
    17th Floor
    New York, NY 10022
    Email: mioh@skadden.com

    NOTE: Email address is different than previously reported

2. Date: 01/12/2012

3. FEC Committee ID #: C00462465 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

C.V. Starr & Co. Inc.
399 Park Avenue
17th Floor
New York, New York 10022
Affiliated Relationship Code: Connected Organization

Starr Insurance Holdings, Inc. Politic
399 Park Avenue
17th Floor
New York, New York 10022
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Howard I. Smith
399 Park Avenue
17th Floor
New York, NY 10022
Title: Custodian of Records

Treasurer:

Howard I. Smith
399 Park Avenue
17th Floor
New York, New York 10022
Title: Treasurer

Designated Agent(s):

Kenneth A. Gross
1440 New York Ave. NW
Washington, DC 200052131
Title: Designated Agent
Phone # (202) 371-7007

Banks or Depositories

J.P. Morgan Chase
3 Chase MetroTech Center, 7th Flr
Mail Code: NY1-H134
Brooklyn, New York 11245

Signed: Howard I. Smith
Date Signed: 01/20/2012

(End FEC FORM 1)

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