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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-747054

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1. MAC PAC

    Po Box 60405
    Worcester, MA 01606

    NOTE: Address is different than previously reported

    Email: Btalcott1@verizon.net

    NOTE: Email address is different than previously reported

2. Date: 10/07/2011

3. FEC Committee ID #: C00461251

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

Candidate ID# H4MA03022
James P McGovern
393 Burncoat Street
Worcester, Massachusetts 01606
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

William T. Talcott, III
444 West Boylston Street
Worcester, MA 01606

Treasurer:

William T. Talcott, III
444 West Boylston Street
Worcester, Massachusetts 01606
Title: Treasurer
Phone # (508) 853-3113

Designated Agent(s):

Mathew Pacheco
10 Mann Street
Medway, Massachusetts 02053
Title: Asst. Treasurer

Banks or Depositories

TD Bank North
PO Box 746
Keene, New Hampshire 03431

Signed: William T. Talcott, III
Date Signed: 10/07/2011

(End FEC FORM 1)

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