Clerk of the House of Representatives • Legislative Resource Center • B-106 Cannon Building • Washington, DC 20515

Secretary of the Senate • Office of Public Records • 232 Hart Building • Washington, DC 20510

Filer Type and Name

Type:

OrganizationLobbyist

Lobbyist Name:

Mr. JEFFREY FORBES

Employer Name:

Cauthen Forbes & Williams

Identification Numbers

House Registrant ID:

36886

Senate Registrant ID:

284551

Reporting Period

Year:

2012

Mid-Year (January 1 - June 30)

Year-End (July 1 - December 31)

Amendment

Political Action Committee Names

Contributions

No Contributions

#1.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$2,500.00

Date:

01/20/2012

Payee:

Soutwest Leadership Fund

Honoree:

Tom Udall

#2.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

02/16/2012

Payee:

Friends of Mazie Hirano

Honoree:

Mazie Hirano

#3.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

03/22/2012

Payee:

Tammy Baldwin for Senate

Honoree:

Tammy Baldwin

#4.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

03/30/2012

Payee:

Tim Kaine for U.S. Senate

Honoree:

Tim Kaine

#5.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$2,400.00

Date:

03/28/2012

Payee:

Bob Kerrey for Nebraska

Honoree:

Bob Kerrey

#6.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

04/19/2012

Payee:

Richard Carmona for Arizona

Honoree:

Richard Carmona

#7.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

05/17/2012

Payee:

Martin Heinrich for Senate

Honoree:

Martin Heinrich

#8.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

03/27/2012

Payee:

DSCC

Honoree:

DSCC

#9.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$2,500.00

Date:

03/22/2012

Payee:

Peak PAC

Honoree:

Mark Udall

#10.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

01/03/2012

Payee:

Udall-Udall Leadership Fund PAC

Honoree:

Mark Udall and Tom Udall

#11.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$2,500.00

Date:

03/29/2012

Payee:

Martin Heinrich for Senate

Honoree:

Martin Heinrich

#12.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$5,000.00

Date:

03/29/2012

Payee:

Heidi for Senate

Honoree:

Heidi Heitkamp

#13.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$5,000.00

Date:

03/29/2012

Payee:

Friends of Chris Murphy

Honoree:

Chris Murphy

#14.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$5,000.00

Date:

03/29/2012

Payee:

Nebraskans for Kerrey

Honoree:

Bob Kerrey

#15.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$15,000.00

Date:

03/29/2012

Payee:

DSCC

Honoree:

DSCC

#16.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$2,500.00

Date:

05/23/2012

Payee:

Kaine for Virginia

Honoree:

Tim Kaine

#17.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$5,000.00

Date:

06/28/2012

Payee:

Friends of Chris Murphy

Honoree:

Chris Murphy

#18.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$5,000.00

Date:

06/28/2012

Payee:

Heidi for Senate

Honoree:

Heidi Heitkamp

#19.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$5,000.00

Date:

06/28/2012

Payee:

Martin Heinrich for Senate

Honoree:

Martin Heinrich

#20.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$5,000.00

Date:

06/28/2012

Payee:

Nebraskans for Kerrey

Honoree:

Bob Kerrey

#21.

Contribution Type:

FECA

Contributor Name:

ModSquad PAC

Amount:

$350.00

Date:

06/28/2012

Payee:

Donnelly for Indiana

Honoree:

Joe Donnelly

Comments

Certification and Signature

I certify that I have read and am familiar with the provisions of the Standing Rules of the Senate and the Standing rules of the House of Representatives relating to the provision of gifts and travel. I have not provided, requested or directed a gift, including travel, to a Member of Congress or an officer or employee of either House of Congress with knowledge that receipt of the gift would violate rule XXXV of the Standing Rules of the Senate or rule XXV of the Rules of the House of Representatives during this filing period.

Digitally Signed By:

JEFFREY FORBES, 7/19/2012 4:38:19 PM