FEC Form 1 for HEARTLAND COMMUNITY BANKERS ASSOCIATION-POLITICAL ACTION COMMITTEE (HCBA-PAC)Form 1 for HEARTLAND COMMUNITY BANKERS ASSOCIATION-POLITICAL ACTION COMMITTEE (HCBA-PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-358162

1. HEARTLAND COMMUNITY BANKERS ASSOCIATION-POLITICAL ACTION COMMITTEE (HCBA-PAC)

700 KANSAS AVENUE SUITE 512
TOPEKA, KS 66603
Fax: 7852329320
Email: dsayler@hcbankers.com

2. Date: 08/19/2008

3. FEC Committee ID #: C00160978 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Heartland Community Bankers Association
700 S Kansas Ave
Suite 512
Topeka, Kansas 66603
Affiliated Relationship Code: Connected Organization

American Bankers Association PAC
1120 Connecticut Ave NW
Suite 600
Washington, DC 20036
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Debbie Sayler
700 S Kansas Ave
Suite 512
Topeka, KS 66603
Title: Assistant Teasurer
Phone # (785) 232-8215

Treasurer:

John C. Dicus
1524 Lakeside Dr
Topeka, Kansas 66604
Title: Treasurer
Phone # (785) 232-8215

Designated Agent(s):

Banks or Depositories

Capitol Federal Savings
700 S Kansas Ave
Topeka, Kansas 66603

Signed: John C. Dicus
Date Signed: 08/19/2008
Official Committee FAX: 7852329320

(End FEC FORM 1)

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