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. JOHN M. SIMMONS

Employer Name:

The Roosevelt Group

Identification Numbers

House Registrant ID:

41976

Senate Registrant ID:

400886595

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:

$250.00

Date:

07/04/2012

Payee:

Richard Hanna for Congress Committee

Honoree:

Richard Hanna

#2.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

09/26/2012

Payee:

AMERIPAC: The Fund for a Greater America

Honoree:

Steny Hoyer

#3.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

07/02/2012

Payee:

Gillibrand for Senate

Honoree:

Kirsten Gillibrand

#4.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

09/26/2012

Payee:

Ann Marie Buerkle for Congress

Honoree:

Ann Marie Buerkle

#5.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

10/08/2012

Payee:

Tommy Thompson for Senate

Honoree:

Tommy Thompson

#6.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

10/26/2012

Payee:

Boehner for Speaker

Honoree:

John Boehner

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:

JOHN SIMMONS, 1/25/2013 3:25:27 PM