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. ROBERT NICHOLS

Employer Name:

FINANCIAL SERVICES FORUM

Identification Numbers

House Registrant ID:

36428

Senate Registrant ID:

83535

Reporting Period

Year:

2011

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:

$150.00

Date:

09/26/2011

Payee:

Bongino for Senate

Honoree:

Bongino for Senate

#2.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

11/02/2011

Payee:

Corker for Senate

Honoree:

Corker for Senate

#3.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

11/09/2011

Payee:

Lingle for Senate

Honoree:

Lingle for Senate

#4.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

11/30/2011

Payee:

Mandel for Senate

Honoree:

Mandel for Senate

#5.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$1,000.00

Date:

12/06/2011

Payee:

Lingle for Senate

Honoree:

Lingle for Senate

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:

ROBERT NICHOLS, 1/3/2012 8:27:38 AM