FEC Form 1 for The Council of Insurance Agents & Brokers Political Action CommitteeForm 1 for The Council of Insurance Agents & Brokers Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-409781

1. The Council of Insurance Agents & Brokers Political Action Committee

701 Pennsylvania Avenue, NW
Suite 750
Washington, DC 200042608
Email: webb.milward@ciab.com

2. Date: 03/26/2009

3. FEC Committee ID #: C00039578 This committee is a separate segregated fund. Its connected organization is a Membership Organization
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Council of Insurance Agents & Brokers
701 Pennsylvania Ave., NW
Suite 750
Washington, DC 20004
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Alicia Y. Anderson
701 Pennsylvania Ave., NW
Suite 750
Washington, DC 200042608
Title: Sr. Accountant
Phone # (202) 662-4429

Treasurer:

Ken A. Crerar
701 Pennsylvnia Ave., NW
Suite 750
Washington, DC 20004
Title: President
Phone # (202) 783-4400

Designated Agent(s):

Banks or Depositories

National Capital Bank of Washington
316 Pennsylvania Ave., SE
Washington, DC 20003

Signed: Ken A. Crerar
Date Signed: 03/26/2009

FORM TEXT

(End FEC FORM 1)

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