FEC Form 1 for Health Agents of America PAC-HAFA-PACForm 1 for Health Agents of America PAC-HAFA-PAC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1159171

1. Health Agents of America PAC-HAFA-PAC

PO Box 65128
Baton Rouge, LA 70896
Email: patchoffman@gmail.com

2. Date: 04/19/2017

3. FEC Committee ID #: C00583492 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

Committee ID# C00583492
Health Agents of America PAC-HAFA-PAC
PO Box 65128
Baton Rouge, Louisiana 70896
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mary Hoffman
10128 Chestnut Oak Dr.
Baton Rouge, LA 70809
Title: Comptroller
Phone # (225) 275-1904

Treasurer:

Sandra Davis
PO Box 148
Watson, Louisiana 70786
Title: Treasurer
Phone # (225) 388-5400

Designated Agent(s):

Banks or Depositories

Capital One Bank
5220 Government
Baton Rouge, Louisiana 70806

Signed: Sandra Davis
Date Signed: 04/19/2017
Official Committee URL: www.HAFAmerica.org

NOTE: URL is different than previously reported

(End FEC FORM 1)

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