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-885259

1. Amerigroup Corporation Political Action Committee (Amerigroup PAC)

4425 Corporation Lane
Virginia Beach, VA 234623103
Email: john.littel@amerigroup.com

2. Date: 08/15/2013

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

WellPoint, Inc. WELLPAC
120 Monument Circle
Indianapolis, Indiana 46204
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

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

Treasurer:

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

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-885259

1. Amerigroup Corporation Political Action Committee (Amerigroup PAC)

2. Date: 08/15/2013

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: John E. Littel
Date Signed: 08/15/2013

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-885259

1. Amerigroup Corporation Political Action Committee (Amerigroup PAC)

2. Date: 08/15/2013

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: John E. Littel Date Signed: 08/15/2013

(End FEC FORM 1)

Signed: John E. Littel
Date Signed: 08/15/2013