FEC Form 1 for Westfield Federal Employee Political Action Committee of Ohio Farmers Insurance CompanyForm 1 for Westfield Federal Employee Political Action Committee of Ohio Farmers Insurance Company

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-716301

1. Westfield Federal Employee Political Action Committee of Ohio Farmers Insurance Company

One Park Circle
P.O. Box 5001
Westfield Center, OH 442515001
Email: gregoryoakes@westfieldgrp.com

2. Date: 01/31/2011

3. FEC Committee ID #: C00376863 This committee is a separate segregated fund. Its connected organization is a

Affiliated Committees/Organizations

Westfield Group
One Park Circle
P.O. Box
Westfield Center, Ohio 44251
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

Gregory Oakes
6672 Smucker Drive
P.O. Box 296
Westfield Center, Ohio 44251

Designated Agent(s):

Sally A. Estvanic
1714 Coyote Run
Valley City, Ohio 44280
Title: Assistant Treasurer
Phone # (330) 887-0992

Banks or Depositories

Westfield Bank
Two Park Circle
Westfield Center, Ohio 44251

Signed: Sally A. Estvanic
Date Signed: 03/04/2011

(End FEC FORM 1)

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