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. JULIAN A HAYWOOD

Employer Name:

FORGE Federal Affairs LLC

Identification Numbers

House Registrant ID:

41918

Senate Registrant ID:

400865535

Reporting Period

Year:

2017

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:

$1,000.00

Date:

01/24/2017

Payee:

Collective PAC

Honoree:

Gregory Meeks, Hank Johnson, Cedric Richmond, Stacey Plaskett, Val Demings, Mark Veasey

#2.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

06/19/2017

Payee:

John Ossoff for Congress

Honoree:

John Ossoff

#3.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$2,700.00

Date:

06/23/2017

Payee:

Jim Clyburn for U.S. Congress

Honoree:

Jim Clyburn

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:

JULIAN HAYWOOD, 8/3/2017 5:15:59 PM