FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-726605
1. Ameritas Life Insurance Corp. Political Action Committee
NOTE:Commmittee Name is different than previously reported
5900 O StreetLincoln, NE 68510
Email: dmeyer@ameritas.com
NOTE: Email address is different than previously reported
2. Date: 04/27/2011
3. FEC Committee ID #: C00187138 This committee is a separate segregated fund. Its connected organization is aAffiliated Committees/Organizations
Ameritas Life Insurance Corp.5900 O Street
Lincoln, Nebraska 68510
Affiliated Relationship Code: Connected Organization
Custodian of Records:
Ms. Diane E. Meyer18311 Tyler Street
Omaha, NE 68135
Title: Treasurer
Phone # (402) 467-7730
Treasurer:
Ms. Diane E. Meyer18311 Tyler Street
Omaha, Nebraska 68135
Title: Treasurer
Phone # (402) 467-7730
Designated Agent(s):
Banks or Depositories
Wells Fargo Bank6600 O Street
Lincoln, Nebraska 68510