FEC Form 1 for Selective Insurance Company of America Political Action CommitteeForm 1 for Selective Insurance Company of America Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1723539

1. Selective Insurance Company of America Political Action Committee

40 Wantage Ave
Branchville, NJ 07890
Email: jeff.beck@selective.com;DLPOLRPTS6@skadden.com

NOTE: Email address is different than previously reported

2. Date: 08/21/2023

3. FEC Committee ID #: C00550889 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Selective Insurance Company of America
40 Wantage Ave
Branchville, New Jersey 07890
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Jeffrey Beck
40 Wantage Ave
Branchville, NJ 07890
Title: Treasurer
Phone # (973) 948-1311

Treasurer:

Jeffrey Beck
40 Wantage Ave
Branchville, New Jersey 07890
Title: Treasurer
Phone # (973) 948-1311

Designated Agent(s):

Banks or Depositories

Atlantic Union Bank
4221 Walney Rd
Suite 120
Chantilly, Virginia 20151

Signed: Jeffrey Beck
Date Signed: 08/24/2023

(End FEC FORM 1)

Generated Sun Nov 17 06:25:07 2024