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1.
FEC FORM 1
NAMEOF COMMITTEE (In full)
STATEMENT OF ORGANIZATiON
Rt:CEIVED~'
2012 APR-5 P |:50 M
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COI\/IMITTEE'S E-MAIL ADDRESS (Please provide only one e-mail address) n I I ( C h e * address is changed) PiyPPq<^"?tf|lx,Cpm i I l l I I I I I II | | I I I I I I STATE ZIP CODE
2. DATE
3.
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F E C IDENTIFICATION N U M B E R
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OR
4.
IS THIS STATEMENT
NEW (N)
AMENDED (A)
/ certify that I have examined this Statement and to the best of my knowledge and tielief it is true, con'ect and complete.
ChrlStOpher Llbertelil
Signature of Treasurer
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NOTE: Submission of false, erroneous, or incomplete infbrmation may subject the person signing this Statement to the penalties of 2 U.S.C 437g. ANY CHANGE IN INFORMATION SHOULD BE REPORTED WITHIN 10 DAYS.
For further Infbrmation contact: Federal Election Commission Toll Free 800-424-9530 Local 202-694-1100
FEC FORM 1
(Revised 02/2009) ^ J
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5. (a) (b)
Candidate Committee:
This committee is a principal campaign committee. (Complete the candidate information below.) This committee is an authorized committee, and is NOT a principal campaign committee. (Complete the candidate information below.)
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II
(c)
This committee supports/opposes only one candidate, and is NOT an authorized committee.
I I I I I I I I I I I I I I I I I I I I I I I I I I I
Name of Candidate
Page 2
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I I I I
Office Sought:
State
House
Senate
President District
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Party Committee:
(d) This committee is a I-"fc""" 1 1^^^^^^ ^ I (National, State or subordinate) committee of the (Democratic, Republican, etc.) Party
This committee supports/opposes more than one Federal candidate, and is NOT a separate segregated fund or party rommittee ^i e nonnonnenterl r^nmmittpp^ committee, (i.e., nonconnected committee) In addition, this committee is a Lobbyist/Registrant PAC. In addition, this committee is a Leadership PAC. (Identify sponsor on line 6.)
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This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political committees/organizations, at least one of which is an authorized committee of a federal candidate. This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political committees/organizations, none of which is an authorized committee of a federal candidate.
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6.
Page 3
Relationship: [^Connected Organization QjAffiliated Committee [~~|joint Fundraising Representative ^^Leadership PAC Sponsor
7.
Custodian of Records: Identify by name, address (phone number ~ optional) and position of the person in possession of committee books and records.
Full Name
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Mailing Address |1 pO|V\(inpl^e^tqr Qlr;
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ZIP CODE
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STATE
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Title or Position
CITY
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Telephone number
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Treasurer: List the name and address (phone number ~ optional) of the treasurer of the committee; and the name and address of any designated agent (e.g., assistant treasurer).
of^TreasTer
Mailing Address
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CITY Title or Position
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STATE
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ZiP CODE
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Telephone number
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FEC Form 1 (Revised 02/2009) Full Name of Agent Mailing Address l l l l Ppllrp g O f l n e i ; I I I I I Page 4 I I I I II I III I II I I I I I I I I I I I I I I I I I
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CITY Title or Position |A^S|St^nt TrQagUfef i i i i i i i i i i I
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STATE ZIP CODE
Telephone number
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9.
Banks or Other Depositories: List all banks or other depositories in which the committee deposits funds, holds accounts, rents safety deposit boxes or maintains funds. Name of Bank, Depository, etc.
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Mailing Address |SpMth,Mar|kQt $ t ^ e ^ t , | 2 i n d , F | 0 Q r I I 'I I I I I I I I' I I CITY Name of Bank, Depository etc.
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STATE
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Mailing Address
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CITY
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STATE
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ZIPCODE
Federal Election Commission ENVELOPE REPLACEMENT PAGE FOR INCOMING DOCUMENTS The FEC added this page to the end of this filing to indicate how it was received. Date of Receipt Hand Delivered
4Mn 71
Postmariced Postmariced (R/C)
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USPS First Class Mail [ USPS Registered/Certified Postmarked I USPS Priority Mail Delivery Confirmation or Signature Confirmation Label I Postmarked I
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I USPS Express Mail [ Postmark Illegible No Postmark Shipping Date I Ovemight Delivery Service (Specify): Next Business Day Delivery I Date of Receipt I
I Received from House Records & Registration Office Date of Receipt Received from Senate Public Records Office Date of Receipt I Received from Electronic Filing Office Date of Receipt or Postmarked I Other (Specify):
%y
PREPARER (3/2005)
DATE PREPARED
4/