FEC Form 1 for BluePAC of Pennsylvania (The Blue Cross and Blue Shield Association)Form 1 for BluePAC of Pennsylvania (The Blue Cross and Blue Shield Association)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-429840

1. BluePAC of Pennsylvania (The Blue Cross and Blue Shield Association)

PO Box 60710
Harrisburg, PA 17106
Email: traci.lumadue@capbluecross.com

2. Date: 11/01/1987

3. FEC Committee ID #: C00270967 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

BLUE PAC, THE BLUE CROSS AND BLUE SHIELD ASSOCIATION POLITIACL ACTION COMMITTEE
C/O BARRY TRIMBLE
1310 G STREET NW
WASHINGTON, DC 20005
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Traci Lumadue
2500 Elmerton Avenue
Harrisburg, PA 171773238
Title: Junior Accountant
Phone # (717) 541-7257

Treasurer:

Robert Baker
2500 Elmerton Ave
Harrisburg, Pennsylvania 171772531
Title: Director Govt. Aff
Phone # (717) 541-6134

Designated Agent(s):

LINDA MELUSKY
2500 ELMERTON AVENUE
HARRISBURG, Pennsylvania 171772531
Title: GOVT AFFAIRS REP
Phone # (717) 541-6135

Banks or Depositories

M&T Bank
213 Market St
Harrisburg, Pennsylvania 17101

Signed: Robert Baker
Date Signed: 08/18/2009
Official Committee URL: www.capbluecross.com

(End FEC FORM 1)

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