FEC Form 1 for MASSACHUSETTS BIOTECHNOLOGY COUNCIL FEDERAL POLITICAL ACTION COMMITTEEForm 1 for MASSACHUSETTS BIOTECHNOLOGY COUNCIL FEDERAL POLITICAL ACTION COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-985708

1. MASSACHUSETTS BIOTECHNOLOGY COUNCIL FEDERAL POLITICAL ACTION COMMITTEE

300 Technology Square, 8th floor
Cambridge, MA 02139
Email: david@chickmontanagroup.com

NOTE: Email address is different than previously reported

2. Date: 01/26/2015

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:

David Martin
202 Bonham Rd
Dedham, MA 02026
Title: Treasurer
Phone # (781) 686-9199

Treasurer:

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

Designated Agent(s):

Banks or Depositories

Citizens Bank
73 Tremont St
Boston, Massachusetts 02108

Signed: David Martin
Date Signed: 01/26/2015

(End FEC FORM 1)

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