FEC Form 1 for BLUE CROSS AND BLUE SHIELD OF NEBRASKA PACForm 1 for BLUE CROSS AND BLUE SHIELD OF NEBRASKA PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1708078

1. BLUE CROSS AND BLUE SHIELD OF NEBRASKA PAC

1919 AKSARBEN DRIVE PO BOX 3248
OMAHA, NE 681800001
Email: David.Sederburg@nebraskablue.com

2. Date: 06/13/2023

3. FEC Committee ID #: C00276311 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

David Sederburg
10220 N 168TH STREET
BENNINGTON, NE 68007
Title: VP Finance
Phone # (402) 889-7046

Treasurer:

David Sederburg
10220 N 168TH STREET
BENNINGTON, Nebraska 68007
Title: VP Finance
Phone # (402) 889-7046

Designated Agent(s):

Denna Hodges
1919 Aksarben Drive
Omaha, Nebraska 68180
Title: Accountant
Phone # (402) 999-3990

Erin Russell
1919 Aksarben Drive
Omaha, Nebraska 68180
Title: Manager
Phone # (208) 661-8286

Jennifer Davenport
1919 Aksarben Drive
Omaha, Nebraska 68180
Title: Accountant
Phone # (402) 321-2155

Banks or Depositories

First National Bank of Omaha
1620 Dodge Street
Omaha, Nebraska 68197

Signed: David Sederburg
Date Signed: 06/20/2023

(End FEC FORM 1)

Generated Thu Jul 18 08:53:30 2024