FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-426792
1. Blue Cross Blue Shield of Alabama PAC
2 North Jackson StreetSuite 202
Montgomery, AL 36104
Email: alcox@comerica.com
2. Date: 07/24/2009
3. FEC Committee ID #: C00457242 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
Blue Cross Blue Shield of Alabama2 North Jackson Street
Suite 202
Montgomery, Alabama 36104
Affiliated Relationship Code: Connected Organization
Custodian of Records:
COMERICA BANKPAC SERVICES MC#2250
P.O. BOX 75000
DETROIT, MI 482752250
Title: RECORD KEEPER
Phone # (248) 371-7271
Treasurer:
Ronald S. SiemiontkowskiComerica Bank PAC Services MC#2250
PO Box 75000
Detroit, Michigan 482752250
Title: TREASURER
Phone # (248) 371-7271
Designated Agent(s):
J. Robin Stone2 North Jackson Street
Suite 202
Montgomery, Alabama 36104
Title: Asst. Treas.
Phone # (334) 262-4657
Banks or Depositories
Comerica BankP.O. Box 75000
PAC Services MC 2250
Detroit, Michigan 482752250