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FEC Form 1 for Independence Blue Cross PAC (IBC PAC)Form 1 for Independence Blue Cross PAC (IBC PAC)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-376324


1. Independence Blue Cross PAC (IBC PAC)

    1901 Market Street
    Philadelphia, PA 19103
    Fax: 2152412444
    Email: lorina.marshall@ibx.com

2. Date: 10/17/2008

3. FEC Committee ID #: C00450056 This committee is a separate segregated fund. Its connected organization is a Corporation W/O Capital Stock

Affiliated Committees/Organizations

Committee ID# C00450056
Independence Blue Cross
1901 Market Street
Philadelphia, Pennsylvania 19103
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Royal E. Brown
1901 Market Street
Philadelphia, PA 19103
Title: Treasurer
Phone # (215) 241-2590

Treasurer:

Royal E. Brown
1901 Market Street
Philadelphia, Pennsylvania 19103
Title: Treasurer
Phone # (215) 241-2590

Designated Agent(s):

Stephen P. Fera
1901 Market Street
Philadelphia, Pennsylvania 19103
Title: Assistant Treasurer
Phone # (215) 241-3027

Banks or Depositories

Wachovia Bank
1339 Chestnut Street
Philadelphia, Pennsylvania 19107

Signed: Royal E. Brown
Date Signed: 10/17/2008
Official Committee FAX: 2152412444

(End FEC FORM 1)


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