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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1506068

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1. Jackson Holdings LLC and Jackson National Life Insurance Company Federal SSF (Jackson National Feder

    1 Corporate Way
    Lansing, MI 489511001
    Email: martha.vozza@jackson.com;outsourcing@aristotle.com

    NOTE: Email address is different than previously reported

2. Date: 03/15/2021

3. FEC Committee ID #: C00686055 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

Committee ID# C00254953
Jackson Holdings LLC and Jackson National Life Insurance Company Separate Segregated Fund (Jackson N
1 Corporate Way
Lansing, Michigan 489511001
Affiliated Relationship Code: Affiliated Committee

Jackson Holdings LLC and Jackson Natio
1105 N Market St
Ste 1300
Wilmington, Delaware 198011241
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Martha Vozza
1 Corporate Way
Lansing, MI 489511001
Title: Custodian of Records
Phone # (517) 367-4055

Treasurer:

Michael Costello
1 Corporate Way
Lansing, Michigan 489511001
Title: Treasurer
Phone # (517) 367-3854

Designated Agent(s):

Martha Vozza
1 Corporate Way
Lansing, Michigan 489511001
Title: Assistant Treasurer
Phone # (517) 367-4055

Banks or Depositories

Northern Trust
50 South Lasalle Street
Chicago, Illinois 60603

Signed: Michael Costello
Date Signed: 03/23/2021

FORM TEXT-1

(End FEC FORM 1)

Generated Sat Aug 31 14:54:16 2024