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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1000795

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1. Fair Shot PAC

    PO Box 361
    Malden, MA 02148
    Email: gemma@chickmontanagroup.com

2. Date: 04/01/2015

3. FEC Committee ID #: C00574970

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
     In addition, this committee is a Leadership PAC.

Affiliated Committees/Organizations

Katherine Clark
PO Box 361
Malden, Massachusetts 02148
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

Gemma W. Martin
202 Bonham Road
Dedham, MA 02026
Title: Treasurer
Phone # (781) 686-9199

Treasurer:

Gemma W. Martin
202 Bonham Road
Dedham, Massachusetts 02026
Title: Treasurer
Phone # (781) 686-9199

Designated Agent(s):

Banks or Depositories

Citizens Bank
73 Tremont St
Boston, Massachusetts 02110

Signed: Gemma W. Martin
Date Signed: 04/01/2015

(End FEC FORM 1)

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