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. JEFFREY FORBES

Employer Name:

Cauthen Forbes & Williams

Identification Numbers

House Registrant ID:

36886

Senate Registrant ID:

284551

Reporting Period

Year:

2010

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:

$3,040.00

Date:

07/20/2010

Payee:

Democratic Senatorial Campaign Committee

Honoree:

DSCC

#2.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$3,040.00

Date:

08/23/2010

Payee:

Democratic Senatorial Campaign Committee

Honoree:

DSCC

#3.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$3,040.00

Date:

9/21/2010

Payee:

Democratic Senatorial Campaign Committee

Honoree:

DSCC

#4.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

09/24/2010

Payee:

Colorado Democratic Party

Honoree:

CDP

#5.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

09/24/2010

Payee:

Louisiana Democratic Party

Honoree:

Contribution to Party

#6.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

09/24/2010

Payee:

Delaware Democratic Party

Honoree:

Contribution to Party

#7.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

09/24/2010

Payee:

Kentucky Democratic Party

Honoree:

Contribution to Party

#8.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

09/24/2010

Payee:

Indiana Democratic Party

Honoree:

Contribution to Party

#9.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

09/24/2010

Payee:

Arkansas Democratic Party

Honoree:

Contribution to Party

#10.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

09/24/2010

Payee:

Missouri Democratic Party

Honoree:

Contribution to Party

#11.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

09/24/2010

Payee:

Scott McAdams

Honoree:

McAdams for US Senate

#12.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

09/24/2010

Payee:

Alaska Democratic Party

Honoree:

Contribution to Party

#13.

Contribution Type:

FECA

Contributor Name:

Mod Squad

Amount:

$5,000.00

Date:

10/21/2010

Payee:

Joe Manchin

Honoree:

Manchin for West Virginia

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:

JEFFREY FORBES, 1/31/2011 2:45:48 PM