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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1498177

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1. LOCKTON INC POLITICAL ACTION COMMITTEE

    444 WEST 47TH STREET
    SUITE 900
    KANSAS CITY, MO 64112
    Email: thumphrey@lockton.com

2. Date: 02/02/2021

3. FEC Committee ID #: C00652529 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Lockton Inc
444 West 47th Street
Suite 900
Kansas City, Missouri 64112
Affiliated Relationship Code: Connected Organization

Custodian of Records:

William Humphrey
444 West 47th Street
Suite 900
Kansas City, MO 64112
Title: Custodian of Records
Phone # (816) 960-9000

Treasurer:

Ronald Buetow
444 West 47th Street
Suite 900
Kansas City, Missouri 64112
Title: Treasurer
Phone # (816) 960-9000

Designated Agent(s):

Inc. Corporate Creations Network
12747 Olive Blvd. #300
St. Louis, Missouri 63141
Title: Designated Agent
Phone # (314) 667-5376

Banks or Depositories

BOK Financial
P.O. Box 26430
Kansas City, Missouri 641966430

Signed: Ronald Buetow
Date Signed: 02/02/2021

(End FEC FORM 1)

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