FEC Form 1 for KANSAS CITY LIFE INSURANCE COMPANY EMPLOYEES' POLITICAL ACTION COMMITTEE-FUND IIForm 1 for KANSAS CITY LIFE INSURANCE COMPANY EMPLOYEES' POLITICAL ACTION COMMITTEE-FUND II

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1136127

1. KANSAS CITY LIFE INSURANCE COMPANY EMPLOYEES' POLITICAL ACTION COMMITTEE-FUND II

3520 BROADWAY
KANSAS CITY, MO 64111
Email: malika.simmons@kclife.com

2. Date: 12/09/2016

3. FEC Committee ID #: C00042663 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

Kansas City Life Insurance Company
3520 Broadway
Kansas City, Missouri 64111
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Malika Simmons
3520 Broadway
Kansas City, MO 64111
Title: Govt Relations
Phone # (816) 753-7299

Treasurer:

Steve Ropp
3520 Broadway
Kansas City, Missouri 64111
Title: Vice President
Phone # (816) 753-7299

Designated Agent(s):

Banks or Depositories

Commerce Bank
1000 Walnut
Kansas City, Missouri 64106

Signed: Steve Ropp
Date Signed: 12/27/2016

FORM TEXT-1

(End FEC FORM 1)

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