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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1530651

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1. Friends of Doc Chai

    144 Blue Hills Road
    North Haven, CT 06473
    Email: amy.f.chai@gmail.com

2. Date: 07/26/2021

3. FEC Committee ID #: C00785634 This committee is a Principal Campaign Committee. Candidate: Dr Amy Fogelstrom Chai, MD
Party: Libertarian
Office Sought: House of Representatives
State is Connecticut in District: 03

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Dr Toby Chu-Chung Chai, MD
24 Worcester Square #3
Boston, MA 02118
Title: Treasurer
Phone # (410) 905-0640

Treasurer:

Dr Toby Chu-Chung Chai, MD
24 Worcester Square #3
Boston, Massachusetts 02118
Title: Treasurer
Phone # (410) 905-0640

Designated Agent(s):

Banks or Depositories

Bank of America
35 Washington Avenue
North Haven, Connecticut 06473

Signed: Dr Toby Chu-Chung Chai, MD
Date Signed: 07/26/2021
Official Committee URL: docchai2022.com

(End FEC FORM 1)

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