LD-203 Contribution Report

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. DALE P DIRKS

Employer Name:

Health and Medicine Counsel of Washington

Identification Numbers

House Registrant ID:

32764

Senate Registrant ID:

17818

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:

$1,000.00

Date:

02/24/2012

Payee:

Jesse Jackson, Jr. for Congress

Honoree:

Congressman Jesse Jackson, Jr.

#2.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

05/16/2012

Payee:

Friends of Rosa DeLauro

Honoree:

Congresswoman Rosa DeLauro

#3.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

04/25/2012

Payee:

Lucille Roybal-Allard for Congress

Honoree:

Congresswoman Lucille Roybal-Allard

#4.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$250.00

Date:

04/25/2012

Payee:

Donna Christensen Campaign

Honoree:

Congresswoman Donna Christensen

#5.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

05/18/2012

Payee:

Congressman Bill Young Campaign Committee

Honoree:

Congressman C.W. Bill Young

#6.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

06/12/2012

Payee:

Friends of Sherrod Brown

Honoree:

Senator Sherrod Brown

#7.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

06/12/2012

Payee:

Friends of Pat Toomey

Honoree:

Senator Pat Toomey

#8.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$250.00

Date:

06/19/2012

Payee:

Honda for Congress

Honoree:

Congressman Mike Honda

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:

DALE DIRKS, 7/27/2012 11:00:57 AM

Lobbying Contribution Report

Filer Type and Name

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Identification Numbers

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Senate Registrant ID:

Reporting Period

Year:

Political Action Committee Names

Contributions

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#2.

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#3.

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#4.

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#5.

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#6.

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#7.

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#8.

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Comments

Certification and Signature

Digitally Signed By: