FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-109598
1. ALLIANZ LIFE INSURANCE CO/FIREMAN'S FUND INSURANCE CO PAC(ALLIANZ LIFE/FIREMAN'S FUND PAC)
591 REDWOOD HWY. BLDG. 4000MILL VALLEY, CA 94941
Email: sscally@nmgovlaw.com
2. Date: 02/20/2004
3. FEC Committee ID #: C00095109 This committee is a Separate Segregated FundAffiliated Committees/Organizations
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA/FIREMAN'S FUND INSURANCE COMPANY777 SAN MARIN DRIVE
NOVATO, California 94998
Relationship: CONNECTED ORGANIZATION
Organization Type: Corporation
Custodian of Records:
STEVEN S. LUCAS591 REDWOOD HIGHWAY #4000
MILL VALLEY, CA 94941
Title: CST
Phone # (415) 389-6800
Treasurer:
KIT H. CROCKER777 SAN MARIN DRIVE A 16
NOVATO, California 94998
Title: Treasurer
Phone # (415) 899-2574
Designated Agent(s):
STEVEN S. LUCAS591 REDWOOD HIGHWAY #4000
MILL VALLEY, California 94941
Title: Assistant Treasurer
Phone # (415) 389-6800
Banks or Depositories
BANK OF MARIN50 MADERA BLVD.
CORTE MADERA, California 94925