FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-1769835
1. Health Agents of America PAC-HAFA-PAC
PO Box 65128Baton Rouge, LA 70896
Email: patchoffman@gmail.com
2. Date: 09/28/2015
3. FEC Committee ID #: C00583492 This committee is a separate segregated fund. Its connected organization is a Trade AssociationAffiliated Committees/Organizations
Health Agents of AmericaPO Box 65128
Baton Rouge, Louisiana 70896
Affiliated Relationship Code: Connected Organization
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 Hoffman10128 Chestnut Oak Dr.
Baton Rouge, LA 70809
Title: Preparer
Phone # (225) 275-1904
Treasurer:
Jennifer ZimmermanPO Box 65128
Baton Rouge, Louisiana 70869
Title: Treasurer
Designated Agent(s):
Banks or Depositories
Capital One Bank5220 Government
Baton Rouge, Louisiana 70806