FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-496942
1. AVIVA USA Corporation POLITICAL ACTION COMMITTEE
7700 Mills Civic ParkwayWest Des Moines, IA 50266
NOTE: Address is different than previously reported
Email: linda.olson@avivausa.com2. Date: 10/08/2010
3. FEC Committee ID #: C00180901 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
Aviva USA Corporation7700 Mills Civic Parkway
West Des Moines, Iowa 50266
Affiliated Relationship Code: Connected Organization
Custodian of Records:
Michael H. Miller7700 Mills Civic Parkway
West Des Moines, IA 50266
Title: Treasurer
Phone # (800) 800-9882
Treasurer:
Michael H. Miller7700 Mills Civic Parkway
West Des Moines, Iowa 50266
Title: Treasurer
Phone # (800) 800-9882
Designated Agent(s):
Banks or Depositories
Bankers Trust Company665 Locust Street
Des Moines, Iowa 50309