FEC Form 1 for CC SERVICES INC COUNTRY POLITICAL ACTION COMMITTEEForm 1 for CC SERVICES INC COUNTRY POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-751841

1. CC SERVICES INC COUNTRY POLITICAL ACTION COMMITTEE

1701 N TOWANDA AVENUE
PO BOX 2020
BLOOMINGTON, IL 617022020
Email: mwright@ilfb.org

NOTE: Email address is different than previously reported

2. Date: 11/03/2011

3. FEC Committee ID #: C00390971 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Megan Wright
1701 Towanda Ave
Bloomington, IL 61702
Title: Staff Accountant
Phone # (309) 557-2489

Treasurer:

David A Magers, Treasurer
1701 Towanda Ave
PO Box 2901
Bloomington, Illinois 617022901
Title: Chief Financial Off
Phone # (309) 557-3886

Designated Agent(s):

Megan Wright
1701 Towanda Ave
Bloomington, Illinois 61702
Title: Staff Accountant
Phone # (309) 557-2489

Peter Borowski
3017 Thornwood Ln
Bloomington, Illinois 61704
Title: Controller
Phone # (309) 821-3312

Banks or Depositories

Commerce Bank
120 N. Center Street
Bloomington, Illinois 617020068

Signed: David A Magers, Treasurer
Date Signed: 11/07/2011
Official Committee URL: www.countryfinancial.com

(End FEC FORM 1)

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