FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-870069
1. Capital BluePAC
NOTE:Commmittee Name is different than previously reported
PO Box 60710Harrisburg, PA 17106
Email: linda.melusky@capbluecross.com
2. Date: 04/04/2012
3. FEC Committee ID #: C00270967 This committee is a separate segregated fund. Its connected organization is a Membership OrganizationAffiliated Committees/Organizations
BluePACc/o Mr. Berry Tremble BCBSA
1310 G Street, NW
Washington, DC 20005
Affiliated Relationship Code: Affiliated Committee
Custodian of Records:
Traci L Lumadue2500 Elmerton Ave
Harrisburg, PA 171779764
Title: Custodian of Records
Treasurer:
Robert Baker2500 Elmerton Ave
Harrisburg, Pennsylvania 171779764
Title: Treasurer
Designated Agent(s):
Banks or Depositories
M&T Bank1002 North 7th Street
Harrisburg, Pennsylvania 17102
M&T Bank
, ____ 0.00
M&T Bank
, ____ 0.00