FEC Form 1 for SENTRY INSURANCE A MUTUAL COMPANY FEDERAL POLITICAL ACTION COMMITTEEForm 1 for SENTRY INSURANCE A MUTUAL COMPANY FEDERAL POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1297823

1. SENTRY INSURANCE A MUTUAL COMPANY FEDERAL POLITICAL ACTION COMMITTEE

1800 DEMING WAY
SUITE 400
MIDDLETON, WI 53562

NOTE: Address is different than previously reported

Email: kati.lorge@sentry.com;kip.kobussen@sentry.com

2. Date: 12/06/2018

3. FEC Committee ID #: C00545194 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

SENTRY INSURANCE A MUTUAL COMPANY
1800 NORTH POINT DRIVE
STEVENS POINT, Wisconsin 54481
Affiliated Relationship Code: Connected Organization

Custodian of Records:

KATI LORGE
1800 DEMING WAY
SUITE 400
MIDDLETON, WI 53562
Title: POL ENGAGEMENT DIR
Phone # (608) 826-3273

Treasurer:

PAUL GWIDT
1800 NORTH POINT DRIVE
STEVENS POINT, Wisconsin 54481
Title: DIR-FIN REPORTING
Phone # (715) 346-6174

Designated Agent(s):

KIP KOBUSSEN
1800 NORTH POINT DRIVE
STEVENS POINT, Wisconsin 54481
Title: CHIEF LEGAL & COMPL
Phone # (715) 346-7009

Banks or Depositories

BMO HARRIS BANK NA
P.O. BOX 755
CHICAGO, Illinois 60690

Signed: PAUL GWIDT
Date Signed: 12/06/2018
Official Committee URL: www.sentry.com

(End FEC FORM 1)

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