FEC Form 1 for Amerigroup Corporation Political Action Committee (Amerigroup PAC)Form 1 for Amerigroup Corporation Political Action Committee (Amerigroup PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-746797

1. Amerigroup Corporation Political Action Committee (Amerigroup PAC)

4425 Corporation Lane
Virginia Beach, VA 23462
Email: jlittel@amerigroupcorp.com

NOTE: Email address is different than previously reported

2. Date: 10/05/2011

3. FEC Committee ID #: C00428102 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

Amerigroup Corporation
4425 Corporation Lane
Virginia Beach, Virginia 23462
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Treasurer:

John Littel
4425 Corporation Lane
Virginia Beach, Virginia 234623103
Title: Treasurer
Phone # (757) 518-3649

Designated Agent(s):