FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-426808
1. Premera Blue Cross Political Action Committee/Premera PAC
7001 220th Street SWMS 355
Mountlake Terrace, WA 98043
Email: alcox@comerica.com
2. Date: 07/24/2009
3. FEC Committee ID #: C00409227 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
Premera Blue Cross7001 220th Street SW
MS 355
Mountlake Terrace, Washington 98043
Affiliated Relationship Code: Connected Organization
BLUEPAC-BCBS Assn PAC
1310 G Street NW
Washington, DC 20005
Affiliated Relationship Code: Affiliated Committee
Custodian of Records:
COMERICA BANKPAC SERVICES MC#2250
P.O. BOX 75000
DETROIT, MI 482752250
Title: RECORD KEEPER
Phone # (248) 371-7271
Treasurer:
Jack McRae7001 220th Street SW
MS 355
Mountlake Terrace, Washington 98043
Title: TREASURER
Phone # (425) 918-5757
Designated Agent(s):
Denise Westmoreland7001 220th Street SW
MS 355
Mountlake, Washington 98043
Title: Public Affairs Speci
Phone # (425) 918-5630
Banks or Depositories
Comerica BankP.O. Box 75000
PAC Services MC 2250
Detroit, Michigan 482752250