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FEC Form 1 for Great West Casualty Company Employee & Agent PACForm 1 for Great West Casualty Company Employee & Agent PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-183907


1. Great West Casualty Company Employee & Agent PAC

    P.O. Box 84550
    Lincoln, NE 685014550

    NOTE: Address is different than previously reported

    Fax: 4023233094
    Email: d.parker@usxpress.com

2. Date: 08/09/2005

3. FEC Committee ID #: C00326496 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Great West Casualty Company
P.O. Box 277
South Sioux City, Nebraska 68776
Relationship: Connected
Organization Type: Corporation

Custodian of Records:


Treasurer:

David Parker
P.O. Box 84550
Lincoln, Nebraska 685014550
Title: Treasurer
Phone # (402) 323-3019

Designated Agent(s):

Banks or Depositories

Siouxland National Bank
P.O. Box 987
South Sioux City, Nebraska 687760987

Signed: David Parker
Date Signed: 08/09/2005
Official Committee FAX: 4023233094

(End FEC FORM 1)


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