FEC FORM 3L

02/2009

Office 

Use 

Only

5. TYPE OF REPORT

(Choose One)

(a) Quarterly Reports:

12-Day Primary (12P) General (12G) Runoff (12R) PRE-Election

Report for the:

Convention (12C)

30-Day

POST-Election General (30G) Runoff (30R) Special (30S)

Report for the:

(b) Monthly 

Report 

Due On:

Feb 20 (M2) May 20 (M5) Aug 20 (M8)

Mar 20 (M3) Jun 20 (M6) Sep 20 (M9)

Apr 20 (M4) Jul 20 (M7) and/or

Semi-annual Report Oct 20 (M10) Jan 31 (YE) and/or

Semi-annual Report

1. NAME OF 

COMMITTEE (in full)

ADDRESS (number and street)

Check if different 

than previously 

reported. (ACC)

TYPE OR PRINT

CITY STATE ZIP CODE

2. FEC IDENTIFICATION NUMBER

6. Covered Period(s)

through

I certify that I have examined this Report and to the best of my knowledge and belief it is true, correct and complete.

Type or Print Name of Treasurer

Signature of Treasurer Date

April 15 

Quarterly Report (Q1)

July 15 

Quarterly Report (Q2)

and/or Semi-annual Report

October 15 

Quarterly Report (Q3)

January 31 

Year-End Report (YE)

and/or Semi-annual Report

July 31 Mid-Year 

Report (Non-election 

Year - PAC/Party) (MY)

and/or Semi-annual Report

in the 

Election on State of

in the 

Election on State of

C

3. IS THIS NEW AMENDED

REPORT (N) OR (A)

(c)

Nov 20 (M11)

Dec 20 (M12)

(Non-Election Year Only) 

Example: If typing, type 

over the lines.

(d)

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

M M / D D / Y Y Y Y

12FE4M5

FEC FORM 3L

REPORT OF CONTRIBUTIONS BUNDLED BY LOBBYISTS/REGISTRANTS

AND LOBBYIST/REGISTRANT PACs

7. Total Reportable Bundled Contributions by 

Lobbyists/Registrants or Lobbyist/Registrant PACs , , .

(a) Quarterly/Monthly/Pre-/Post-Election Covered Period (b) Semi-annual Covered Period

STATE DISTRICT

For Candidates Only

4.

and/or January 1 - June 30

July 1 - December 31

M M / D D / Y Y Y Y

, , .

This report also covers 

the semi-annual period Special (12S)

See Line 6(b)

See Line 6(b)

This report also covers 

the semi-annual period

(Non-Election Year Only) 

(a) Quarterly/Monthly/Pre-/Post-Election Covered Period (b) Semi-annual Covered Period

This report covers

NOTE: Submission of false, erroneous, or incomplete information may subject the person signing this Report to the penalties of 52 U.S.C. §30109.
A. Full Name of Lobbyist/Registrant (Last, First, Middle Initial) or Lobbyist/Registrant PAC

Mailing Address

City State Zip Code 

Name of Employer 

FEC ID number of Lobbyist/Registrant

PAC, if applicable. C

B. Full

Mailing Address

City State Zip Code 

Name of Employer 

C

C. Full

Mailing Address

City State Zip Code 

Name of Employer 

C

FEC ID number of Lobbyist/Registrant

PAC, if applicable.

FEC ID number of Lobbyist/Registrant

PAC, if applicable.

SCHEDULE A (FEC Form 3L)

REPORTABLE BUNDLED CONTRIBUTIONS FORWARDED BY OR CREDITED TO

LOBBYISTS/REGISTRANTS AND LOBBYIST/REGISTRANT PACs

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions 

or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

D. Full

Mailing Address

City State Zip Code 

Name of Employer 

C FEC ID number of Lobbyist/Registrant

PAC, if applicable.

, , .

, , . SUBTOTAL reported on this page (optional)

TOTAL reported (last page only) , , .

, , .

Quarterly/Monthly/Pre-/Post-Election Covered Period Semi-annual Covered Period

Name of Lobbyist/Registrant (Last, First, Middle Initial) or Lobbyist/Registrant PAC

Name of Lobbyist/Registrant (Last, First, Middle Initial) or Lobbyist/Registrant PAC

Name of Lobbyist/Registrant (Last, First, Middle Initial) or Lobbyist/Registrant PAC

, , .

Semi-annual Covered Period

Reportable Bundled Contributions during:

Quarterly / Monthly / Pre-Election 

or Post-Election Covered Period

Semi-annual Covered Period

Reportable Bundled Contributions during:

Quarterly / Monthly / Pre-Election 

or Post-Election Covered Period

, , .

, , .

Semi-annual Covered Period

Reportable Bundled Contributions during:

Quarterly / Monthly / Pre-Election 

or Post-Election Covered Period

, , .

Semi-annual Covered Period

Reportable Bundled Contributions during:

Quarterly / Monthly / Pre-Election 

or Post-Election Covered Period
SCHEDULE B (FEC Form 3L)

REFUNDS OF BUNDLED CONTRIBUTIONS FORWARDED BY OR CREDITED TO 

LOBBYISTS/REGISTRANTS AND LOBBYIST/REGISTRANT PACs 

Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions

or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee.

NAME OF COMMITTEE (In Full)

FEC Schedule B (Form 3L) (02/2009)

Full

Mailing Address

City State Zip Code 

A.

Full

Mailing Address

City State Zip Code 

B.

Full

Mailing Address

City State Zip Code 

C.

Full

Mailing Address

City State Zip Code 

D.

Full

Mailing Address

City State Zip Code 

E. Name of Lobbyist/Registrant (Last, First, Middle Initial) or Lobbyist/Registrant PAC

Name of Lobbyist/Registrant (Last, First, Middle Initial) or Lobbyist/Registrant PAC

Name of Lobbyist/Registrant (Last, First, Middle Initial) or Lobbyist/Registrant PAC

Name of Lobbyist/Registrant (Last, First, Middle Initial) or Lobbyist/Registrant PAC

Name of Lobbyist/Registrant (Last, First, Middle Initial) or Lobbyist/Registrant PAC

Semi-annual Covered Period

Refunds of Bundled Contributions during:

, , .

, , . SUBTOTAL reported on this page (optional)

TOTAL reported (last page only) , , .

, , .

Quarterly/Monthly/Pre-/Post-Election Covered Period Semi-annual Covered Period

Quarterly / Monthly / Pre-Election 

or Post-Election Covered Period

Semi-annual Covered Period

Refunds of Bundled Contributions during:

Quarterly / Monthly / Pre-Election 

or Post-Election Covered Period

Semi-annual Covered Period

Refunds of Bundled Contributions during:

Quarterly / Monthly / Pre-Election 

or Post-Election Covered Period

Semi-annual Covered Period

Refunds of Bundled Contributions during:

Quarterly / Monthly / Pre-Election 

or Post-Election Covered Period

Semi-annual Covered Period

Refunds of Bundled Contributions during:

Quarterly / Monthly / Pre-Election 

or Post-Election Covered Period