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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-774114

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1. MASSACHUSETTS BIOTECHNOLOGY COUNCIL FEDERAL POLITICAL ACTION COMMITTEE

    300 Technology Square, 8th floor
    Cambridge, MA 02139

    NOTE: Address is different than previously reported

    Email: david@chickmontanagroup.com

    NOTE: Email address is different than previously reported

2. Date: 04/10/2012

3. FEC Committee ID #: C00380733 This committee is a separate segregated fund. Its connected organization is a Trade Association
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

MASSACHUSETTS BIOTECHNOLOGY COUNCIL INC
300 Technology Square, 8th floor
Cambridge, Massachusetts 02139
Affiliated Relationship Code: Connected Organization

Custodian of Records:

John Heffernan
Mass Biotechnology Council
300 Technology Square, 8th floor
Cambridge, MA 02139
Title: Treasurer
Phone # (617) 647-5100

Treasurer:

John Heffernan
Mass Biotechnology Council
300 Technology Square, 8th floor
Cambridge, Massachusetts 02139
Title: Treasurer
Phone # (617) 647-5100

Designated Agent(s):

David Martin
202 Bonham Rd
Dedham, Massachusetts 02026
Title: Assistant Treasurer

Banks or Depositories

Citizens Bank
73 Tremont St
Boston, Massachusetts 02108

Signed: John Heffernan
Date Signed: 04/10/2012

(End FEC FORM 1)

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