FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-268661
1. Great-West Life & Annuity Insurance Company Political Action Committee
8515 E. Orchard Road7T2
Greenwood Village, CO 80111
Fax: 303-737-3827
Email: robert.onstad@gwl.com
2. Date: 08/03/2006
3. FEC Committee ID #: C00263723 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Custodian of Records:
Treasurer:
Robert Onstad8515 E. Orchard Road
7T2
Greenwood Village, Colorado 80111
Title: Asst. Vice-President
Phone # (303) 737-2016
Designated Agent(s):
Banks or Depositories
US BankP.O. Box 1800
St. Paul, Minnesota 55101