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-739187

1. Great West Casualty Company Employee & Agent PAC

P.O. Box 277
South Sioux City, NE 68776
Email: n.herkowitz@gwccnet.com

NOTE: Email address is different than previously reported

2. Date: 07/28/2011

3. FEC Committee ID #: C00326496 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Committee ID# C00326496
Great 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. Parker
P.O. Box 277
South Sioux City, NE 68776
Title: Treasurer
Phone # (402) 494-2411

Treasurer:

David R. Parker
P.O. Box 277
South Sioux City, Nebraska 68776
Title: Treasurer
Phone # (402) 494-2411

Designated Agent(s):

Banks or Depositories

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

Signed: David R. Parker
Date Signed: 07/28/2011

(End FEC FORM 1)

Generated Wed Jul 17 20:24:33 2024