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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-753936

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1. Campaign for Change

    1147 Hancock St Suite 212
    Quincy, MA 02169

    NOTE: Address is different than previously reported

    Email: info@campaignforchange.co

    NOTE: Email address is different than previously reported

2. Date: 12/01/2011

3. FEC Committee ID #: C00441501

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

None
, ____

Custodian of Records:

Thomas R Kiley
803 Hancock St
Quincy, MA 02170
Title: Treasurer
Phone # (617) 934-4786

Treasurer:

Thomas R Kiley
803 Hancock St
Quincy, Massachusetts 02170
Title: Treasurer
Phone # (617) 934-4786

Designated Agent(s):

Nickolai S Bobrov
1147 Hancock St
Quincy, Massachusetts 02169
Title: Assistant Treasurer

Banks or Depositories

Citizens Bank
73 Tremont St
Boston, Massachusetts 02108

Fidelity Investments
PO Box 770001
Cincinnati, Ohio 45277

Signed: Thomas R. Kiley
Date Signed: 12/01/2011

(End FEC FORM 1)

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