FEC Form 1 for Zephyr Teachout for CongressForm 1 for Zephyr Teachout for Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1092773

1. Zephyr Teachout for Congress

PO Box 491
Rosendale, NY 12472
Email: info@zephyrteachoutforcongress.com;fec@nextlevelpartners.net

NOTE: Email address is different than previously reported

2. Date: 08/05/2016

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

Committee ID# C00623116
Teachout Victory Fund
PO Box 491
Rosendale, New York 12472
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

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

Treasurer:

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

Designated Agent(s):

Banks or Depositories

Bank of America
451 Washington Ave
Kingston, New York 12401

Signed: Jennifer May
Date Signed: 06/21/2016
Official Committee URL: http://www.zephyrteachoutforcongress.com

(End FEC FORM 1)

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