FEC Form 1 for Great-West Life & Annuity Insurance Company Political Action Committee ('A Great-West Financial Political Action CommittForm 1 for Great-West Life & Annuity Insurance Company Political Action Committee ('A Great-West Financial Political Action Committ

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1050392

1. Great-West Life & Annuity Insurance Company Political Action Committee ('A Great-West Financial Political Action Committ

8515 E. Orchard Road
7T2
Greenwood Village, CO 80111
Email: GreatWest_Financial_PAC@greatwest.com;kcrowley@skadden.com

NOTE: Email address is different than previously reported

2. Date: 02/18/2016

3. FEC Committee ID #: C00263723 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Great-West Life & Annuity Insurance Company
8515 E. Orchard Road
7T2
Greenwood Villiage, Colorado 80111
Affiliated Relationship Code: Connected Organization

Committee ID# C00289595
Putnam Investments, LLC Political Acti
One Post Office Square
Boston, Massachusetts 02109
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00571125
Empower - A Great-West Life & Annuity
8515 E. Orchard Road
Number 7T2
Greenwood Village, Colorado 80111
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Treasurer:

Robert Onstad
8515 E. Orchard Road
Number 7T2
Greenwood Village, Colorado 80111
Title: Treasurer
Phone # (303) 737-2106

Designated Agent(s):

Banks or Depositories

US Bank
P.O. Box 1800
Saint Paul, Minnesota 551010800

Signed: Robert Onstad
Date Signed: 02/18/2016

(End FEC FORM 1)

Generated Sun Sep 1 17:41:41 2024