FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-266988
1. Highmark Health PAC of Highmark Inc.
1800 Center StreetCamp Hill, PA 17089
NOTE: Address is different than previously reported
Fax: 7173023969Email: toni.theis@highmark.com
2. Date: 01/03/2007
3. FEC Committee ID #: C00302844 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Highmark Inc.1800 Center Street
Camp Hill, Pennsylvania 17089
Relationship: Connected
Organization Type: Corporation W/O Capital Stock
Custodian of Records:
Toni Theis144 Hiddenwood Drive
Harrisburg, PA 17110
Title: Govt Affairs Coord
Phone # (717) 302-3977
Treasurer:
Gayeta C. Porter1800 Center Street
Camp Hill, Pennsylvania 17011
Title: PAC Treasurer
Phone # (717) 302-6651
Designated Agent(s):
Banks or Depositories
Citizens Bank of Pennsylvania10 South Market Square
PO Box 1010
Harrisburg, Pennsylvania 17108