FEC Form 1 for Independent Insurance Agents of America Political Action Committee (InsurPac)Form 1 for Independent Insurance Agents of America Political Action Committee (InsurPac)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-25133

1. Independent Insurance Agents of America Political Action Committee (InsurPac)

412 First Street SE Suite 300
Washington, DC 20003
Email: lleger@iiaa.net

2. Date: 01/27/2002

3. FEC Committee ID #: C00022343 This committee is an Authorized Committee,
and is NOT a Principal Campaign Committee. Candidate:
Party:
Office Sought:
State is in District:

Affiliated Committees/Organizations

Independent Insurance Agents of America Inc.
127 S. Peyton Street
Alexandria, Virginia 22314
Relationship: Connected
Organization Type: Trade Association

Custodian of Records:

Mr. Robert Rusbuldt
412 First Street SE Suite 300
Washington, DC 20003
Title: CEO
Phone # (202) 863-7000

Treasurer:

Mr. Robert Rusbuldt
412 First Street SE Suite 300
Washington, DC 20003
Title: CEO
Phone # (202) 863-7000

Designated Agent(s):

Banks or Depositories

Sequoia Bank
1001 G Street NW
Washington, DC 20001

Signed: Robert Rusbuldt
Date Signed: 01/29/2002

FORM TEXT

(End FEC FORM 1)

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