FEC Form 1 for Blue Cross and Blue Shield of North Carolina Employee Political Action CommitteeForm 1 for Blue Cross and Blue Shield of North Carolina Employee Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1143287

1. Blue Cross and Blue Shield of North Carolina Employee Political Action Committee

P.O. Box 2291
Durham, NC 27702
Email: katie.ward@bcbsnc.com;BluePac@bcbsnc.com

2. Date: 01/30/2017

3. FEC Committee ID #: C00312223 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Committee ID# C00312223
Blue Cross and Blue Shield of North Carolina Employee Political Action Committee
P.O. Box 2291
Durham, North Carolina 27702
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

, ____

Designated Agent(s):

Banks or Depositories

BB&T
4011 University Drive
Durham, North Carolina 27707

Signed: Kathryn Millican
Date Signed: 01/30/2017

(End FEC FORM 1)

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