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:

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:

$500.00

Date:

09/30/2012

Payee:

Debbie Wasserman Schultz for Congress

Honoree:

Rep. Debbie Wasserman Schultz

#2.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

09/30/2012

Payee:

Larson for Congress

Honoree:

Rep. John Larson

#3.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

09/30/2012

Payee:

Oceguera for Congress

Honoree:

Hon. John Oceguera

#4.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$250.00

Date:

10/19/2012

Payee:

Friends of Patrick Murphy

Honoree:

Patrick Murphy

#5.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$2,500.00

Date:

10/10/2012

Payee:

AMERIPAC: THE FUND FOR A GREATER AMERICA

Honoree:

Rep. Steny Hoyer

#6.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

09/13/2012

Payee:

Connolly for Congress

Honoree:

Rep. Gerald Connolly

#7.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

09/30/2012

Payee:

Horsford for Congress

Honoree:

Hon. Steven Horsford

#8.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$250.00

Date:

10/31/2012

Payee:

Oceguera for Congress

Honoree:

Hon. John Oceguera

#9.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$100.00

Date:

11/05/2012

Payee:

Debbie Wasserman Schultz for Congress

Honoree:

Rep. Debbie Wasserman Schultz

#10.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

08/22/2012

Payee:

Heinrich for Senate

Honoree:

Rep. Martin Heinrich

#11.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

07/20/2012

Payee:

Horsford for Congress

Honoree:

Hon. Steven Horsford

#12.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

09/30/2012

Payee:

Henry Waxman for Congress

Honoree:

Rep. Henry Waxman

#13.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

09/30/2012

Payee:

Chris Murphy for Senate

Honoree:

Rep. Chris Murphy

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, 1/31/2013 11:41:55 PM