FEC Form 1 for Acacia Life Insurance Company PACForm 1 for Acacia Life Insurance Company PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-429250

1. Acacia Life Insurance Company PAC

7315 Wisconsin Ave
Bethesda, MD 20814
Email: jim.harvey@acaciagroup.com

2. Date: 08/11/2009

3. FEC Committee ID #: C00169789 This committee is a separate segregated fund. Its connected organization is a Corporation W/O Capital Stock

Affiliated Committees/Organizations

Acacia Life Insurance Company
7315 Wisconsin Ave
Bethesda, Maryland 20814
Affiliated Relationship Code: Connected Organization

Committee ID# C00187138
AMERITAS FINANCIAL SERVICES PAC
5900 O Street
Lincoln, Nebraska 68510
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00179010
UNION CENTRAL LIFE INSURANCE COMPANY P
P O BOX 40888
1876 WAYCROSS ROAD
CINCINNATI, Ohio 45240
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Treasurer:

James Harvey
7315 Wisconsin Ave
Bethesda, Maryland 20814

Designated Agent(s):

Banks or Depositories

Acacia Federal Savings Bank
7600 Leesburg Pike
Falls Church, Virginia 22043

Signed: James Harvey
Date Signed: 08/11/2009

(End FEC FORM 1)

Generated Sun Aug 25 15:20:25 2024