FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-996802
1. Great-West Life & Annuity Insurance Company Political Action Committee ('A Great-West Financial Political Action Committ
8515 E. Orchard Road7T2
Greenwood Village, CO 80111
Email: GreatWest_Financial@greatwest.com,kcrowley@skadden.com
NOTE: Email address is different than previously reported
2. Date: 03/13/2015
3. FEC Committee ID #: C00263723 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
Great-West Life & Annuity Insurance Company8515 East Orchard Road
7T2
Greenwood Village, Colorado 80111
Affiliated Relationship Code: Connected Organization
Putnam Investments, LLC Political Acti
One Post Office Square
Boston, Massachusetts 02109
Affiliated Relationship Code: Affiliated Committee
Empower - A Great-West Life & Annuity
8515 East Orchard Rd.
Number 7T2
Greenwood Village, Colorado 80111
Affiliated Relationship Code: Affiliated Committee
Custodian of Records:
Mr. Robert Onstad8515 East Orchard Rd.
7T2
Greenwood Village, CO 80111
Title: Treasurer
Phone # (303) 737-2016
Treasurer:
Mr Robert Onstad8515 E. Orchard Road
7T2
Greenwood Village, Colorado 80111
Title: Treasurer
Phone # (303) 737-2016
Designated Agent(s):
Robert Onstad8515 East Orchard Road
Number 7T2
Greenwood Village, Colorado 80111
Title: Treasurer
Phone # (303) 737-2016
Banks or Depositories
US BankP.O. Box 1800
Saint Paul, Minnesota 551010800