FEC Form 1 for American Fidelity Corporation Political Action CommitteeForm 1 for American Fidelity Corporation Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-800754

1. American Fidelity Corporation Political Action Committee

2000 N. Classen Blvd.
Suite 7N
Oklahoma City, OK 73106

NOTE: Address is different than previously reported

Email: steve.garrett@af-group.com

2. Date: 07/23/2012

3. FEC Committee ID #: C00210526 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

American Fidelity Corporation
2000 N. Classen Blvd.
Suite 7N
Oklahoma City, Oklahoma 73106
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Stephen P. Garrett
2000 N. Classen Blvd.
Suite 7N
Oklahoma City, OK 73106
Title: Deputy Treasurer
Phone # (405) 523-5200

Treasurer:

Robert D. Brearton
2000 N. Classen Blvd.
Suite 10E
Oklahoma City, Oklahoma 73106
Title: Treasurer
Phone # (405) 416-8554

Designated Agent(s):

Stephen P. Garrett
2000 N. Classen Blvd.
Suite 7N
Oklahoma City, Oklahoma 73106
Title: Deputy Treasurer
Phone # (405) 523-5200

Banks or Depositories

Merrill Lynch Bank & Trust Co.
One Financial Center, 23rd Floor
Boston, Massachusetts 02111

MidFirst Bank
501 NW Grand Blvd.
Oklahoma City, Oklahoma 73118

Signed: Robert D. Brearton
Date Signed: 07/23/2012
Official Committee URL: www.afweb.afg/pac/index.htm

(End FEC FORM 1)

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