FEC Form 1 for American Family Mutual Insurance Company, S.I. Federal PAC (AMFAM PAC)Form 1 for American Family Mutual Insurance Company, S.I. Federal PAC (AMFAM PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1162679

1. American Family Mutual Insurance Company, S.I. Federal PAC (AMFAM PAC)

NOTE:Commmittee Name is different than previously reported

6000 American Parkway
Madison, WI 53783
Email: politicalaction@amfam.com

2. Date: 05/17/2017

3. FEC Committee ID #: C00354290 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

American Family Mutual Insurance Company, S.I.
6000 American Parkway
Madison, Wisconsin 53783
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Jessica Alanis
6000 American Parkway
Madison, WI 53783
Title: Custodian of Records
Phone # (608) 249-2111

Treasurer:

Lee Fanshaw
6000 American Pkwy
Madison, Wisconsin 53783
Title: Treasurer
Phone # (608) 249-2111

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1162679

1. American Family Mutual Insurance Company, S.I. Federal PAC (AMFAM PAC)

NOTE:Commmittee Name is different than previously reported

2. Date: 05/17/2017

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Lee Fanshaw
Date Signed: 05/17/2017

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1162679

1. American Family Mutual Insurance Company, S.I. Federal PAC (AMFAM PAC)

NOTE:Commmittee Name is different than previously reported

2. Date: 05/17/2017

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Lee Fanshaw Date Signed: 05/17/2017

(End FEC FORM 1)

Signed: Lee Fanshaw
Date Signed: 05/17/2017