FEC Form 1 for BROOKE HOLDINGS INC AND JACKSON NATIONAL LIFE INSURANCE COMPANY SSF (Jackson National PAC)Form 1 for BROOKE HOLDINGS INC AND JACKSON NATIONAL LIFE INSURANCE COMPANY SSF (Jackson National PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-726075

1. BROOKE HOLDINGS INC AND JACKSON NATIONAL LIFE INSURANCE COMPANY SSF (Jackson National PAC)

NOTE:Commmittee Name is different than previously reported

1 Corporate Way
LANSING, MI 48951
Email: cindy.dolan@jackson.com

2. Date: 04/21/2011

3. FEC Committee ID #: C00254953 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Jackson National Life Insurance Company
1 Corporate Way
Lansing, Michigan 48951
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Cynthia Dolan
9741 Sunny Pointe Drive
Laingsburg, MI 48848
Title: GR Specialist
Phone # (517) 367-4358

Treasurer:

Mr. Robert Fritts
2411 Sugar Tree
Lansing, Michigan 48917
Title: Senior VP
Phone # (517) 702-2431

Designated Agent(s):

Banks or Depositories

JP Morgan Chase Bank, NA--Michigan/Flo
P.O. Box 260180
Baton Rouge, Louisiana 708260180

Signed: Mr. Robert Fritts
Date Signed: 04/21/2011

(End FEC FORM 1)

Generated Tue Aug 27 11:17:36 2024