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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1483414

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1. The National MENTOR Holdings, Inc. Fund

    313 Congress Street
    5th Floor
    Boston, MA 02210
    Email: david.baird@thementornetwork.com;chanta.combs@thementornetwork.com

    NOTE: Email address is different than previously reported

2. Date: 12/11/2020

3. FEC Committee ID #: C00750331 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

The MENTOR Network
313 Congress Street
5th Floor
Boston, Massachusetts 02210
Affiliated Relationship Code: Connected Organization

Custodian of Records:

David Baird
313 Congress Street
5th Floor
Boston, MA 02210
Title: Treasurer
Phone # (617) 790-4208

Treasurer:

David Baird
313 Congress Street
5th Floor
Boston, Massachusetts 02210
Title: Treasurer
Phone # (617) 790-4208

Designated Agent(s):

Chanta Combs
1514 Cristobal Drive
Tallahassee, Florida 32303
Title: Assistant Treasurer
Phone # (850) 980-6610

Banks or Depositories

Bank of America
Seaport Square Financial Center
7 Fan Pier Blvd
Boston, Massachusetts 02210

Signed: David Baird
Date Signed: 12/19/2020

(End FEC FORM 1)

Generated Wed Jul 24 02:13:09 2024