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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1053030

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1. Zephyr Teachout for Congress

    PO Box 491
    Rosendale, NY 12472

    NOTE: Address is different than previously reported

    Email: zephyrteachoutforcongress@gmail.com;fec@nextlevelpartners.net

    NOTE: Email address is different than previously reported

2. Date: 03/03/2016

3. FEC Committee ID #: C00608174 This committee is a Principal Campaign Committee. Candidate: Zephyr Teachout
Party: Democratic Party
Office Sought: House of Representatives
State is New York in District: 19

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Jennifer May
PO Box 491
Rosendale, NY 12472
Title: Deputy Treasurer
Phone # (202) 505-1657

Treasurer:

Michael Boland
PO Box 491
Rosendale, New York 12472
Title: Treasurer

Designated Agent(s):

Jennifer May
PO Box 491
Rosendale, New York 12472
Title: Deputy Treasurer
Phone # (202) 505-1657

Banks or Depositories

Bank of America
451 Washington Ave
Kingston, New York 12401

Signed: Michael Boland
Date Signed: 03/03/2016
Official Committee URL: http://www.zephyrteachoutforcongress.com

(End FEC FORM 1)

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