FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-417248
1. Great West Casualty Company Employee & Agent PAC
P.O. Box 277South Sioux City, NE 68776
NOTE: Address is different than previously reported
Email: k.myers@gwccnet.comNOTE: Email address is different than previously reported
2. Date: 05/14/2009
3. FEC Committee ID #: C00326496 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
Committee ID# C00326496Great West Casualty Company Employee & Agent PAC
P.O. Box 277
South Sioux City, Nebraska 68776
Affiliated Relationship Code: Connected Organization
Custodian of Records:
David R. ParkerP.O. Box 277
South Sioux City, NE 68776
Title: Treasurer
Phone # (402) 494-2411
Treasurer:
David R. ParkerP.O. Box 277
South Sioux City, Nebraska 68776
Title: Treasurer
Phone # (402) 494-2411
Designated Agent(s):
Banks or Depositories
Siouxland National BankP.O. Box 987
South Sioux City, Nebraska 687760987