RECEiV"^ VIA OVERNIGHT MAIL 2012MAR27 AMIh 19 FEC MAIL CENTLR COMMITTEE NAME: DogPAC March 23, 2012 HI 0 HI Federal Election Commission 999 E Street N.W. Washington, D.C. 20463 Re: Form 1, Statement of Organization--Unlimited Contributions ^ O m 0 Dear Sir or Madam: Hi This committee intends to make independent expenditures, and consistent with the U.S. Court of Appeals for the District of Columbia Circuit decision in SpeechNow v. FEC, it therefore intends to raise funds in unlimited amounts. This committee will not use those funds to make contributions, whether direct, in-kind, or via coordinated communications, to federal candidates or committees. Respectfully submitted. Ron Carver Treasurer FEC F0RM1 1. NAMEOF COMMITTEE (in full) STATEMENT OF ORGANIZATION (See instructions) (Check if name is changed) Example: If typying, type over the lines 2012HAR 27 flM||:|9 Office use only ' o 12FE4M5, ,, ,, qoqPAC I I i I >> I ' I I I I I I I I I I I I I I I I I I I I t I I ' << I I ' I ' ' I I t I I I I \ I ' ' I I I I I I I I \ t i l l I I I I I I I LI ' I ' I ' I ' I I I I I ' ' I I I I I I I I I I I ' I I I I I ' ' ADDRESS (number and street) ^ 1205 Prospect Street, I T ' I I I I ' I I [L.IJ L.il n (Check if address is changed) is< I I I I I ' I I I I I 'akoina.Park, I T I I I I I I I I I I I I CITYA 20912 STATE A . - l l l l ZIP CODE A . COMMITTEE'S E-MAIL ADDRESS (Please provkie only one e-mail address) LJ (Check if address is changed) I Contact@gooddogbadromney.com l i l t >^ I I * 1 I I 1^ I T l l i i i i I I I ' I I I ' I I I I ' I 'I I l l l l ' COMMITTEE'S WEB PAGE ADDRESS (URL) ~1 l! (Check if address is changed) I I I I www.GoodDogBaclRomney.com I I I ' I ' I I I I '^ I ' I ' ' I ' I ' I ' I ' I I I ' I I I I I I I I I I I I I I I l l l l l l i l l l 2. 3. 4. DATE y] ' D D LA3.J, _2_3j / Y Y Y Y 1 _ 2 OJ 2, ! FEC IDENTiFICATiON NUMBER IS THIS STATEMENT [Sj NEW(N) OR Q AMENDED (A) I oertiiy that I have examined this Statement and to the best of my knowledge and belief it is true, oorrect and complete Type or Print Name of Treasurer Carver fM"^' M "ll / oY-ir-Y">--"Y"j' Signature ofTreasurer Date NOTE: Submission offeiise,erroneous, or incomplete infbrmation may subject the person signing this Statement to the penalties of 2 U.S.C. ?437g. ANY CHANGE IN INFORMATION SHOULD BE REPORTED WITHIN 10 DAYS Office Use Only For further Infbrmation contact: Federal Election Commission Toii Free 800424-9530 Locai 202-694-1100 FEC FORM 1 (Revised 02/2009) FEC Forml (Revised 02/2009) 5. TYPE OF COMMITTEE (Check One) Candidate Committee: Page 2 ril (a) (b) [LJ [I.J This committee is a principal campaign committee. (Complete the candidate infonnation lielow.) This committee is an authorized committee, and is NOT a principal campaign committee. (Complete the candidate infonnation below.) Name of Candidate l l l l l l I I I I I I I I I I I I I I I I I I I I l l l l l l Candidate Party Affiliation Office Sought: State Q House ILJ Senate Ql President District (c) Name of Candidate This committee supports/opposes only one candidate, and is NOT an authorized committee. I I I I I I I I I 1 I I I I I I I I I I I I I I I I I I I I I I I I Party Committee: (d) n This committee is a (National, State (or subordinate) committee of the (Democratic, Republican,etc.) Party. Poiiticai Action Committee (PAC): This committee is a separate segregated fund. (Identify connected organization on line 6.) Its connected organization is a: (e) ni<< o (f) |x] ' [i Jl Corporation J Membership Organization n i[ | Corporation w/o Capital stock { Trade /^sociation [~] Labor Organization P I Cooperative {rl| In addition, this committee is a Lobbyist/Registrant PAC. This committee supports/opposes more than one Federal candklate, and is NOT a separate segregated fund or party committee, (i.e., nonconnected committee) In addition, this committee is a Lobbyist/Registrant PAC. P J In addition, this committee is a Leadership PAC. (Identify sponsor on line 6.) Joint Fundraising Representative: (9) r { This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political ! committees/organizations, at least one of which is an authorized committee of a federai candidate. This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political committees/organizations, none of which is an authorized committee of a federal candidate. Committees Participating in Joint Fundraiser 1. 2. 3. 4. Ill l l l l l l i l l l ' (h) Ill ' FEC ID number FEC ID number FEC ID number FEC ID number ii I I I I I I I I I I I I 1 I I I i I I I I I I I I I I I I I I ' I I I I I I FEC Forml (Revised 02/2009) Write or Type Committee Name DogPAC Pages 6. Name of Any Connected Organization, AfRliatsd Committee, Joint Fundraising Representative, or Leadership PAC Sponsor I ."PNF I l l l l l l I l l l l l l I l l Mailing Address I I I I I I I I I CITYA I I I I I I I I I I I I I I I I I I ' I I I I I I J L U STATEA i I I I I l-i I ZIP CODE A Relationship: Connected Organization o Affiliated Committee I o I Joint Fundraising Representative | I Leadership PAC Sponsor 7. Custodian of Records: Identify by name, address, (phone number ~ optional), and position of the person In possession of Committee books and records. Full Name Mailing Address Ron Carver I I I I I I I I I I I I I I I I I I I I I I I I I I l l l l 1205 Prospect Street Takoma Park Title or Position V Treasurer CITYA MD STATEA Telephone number 301 20912 - ZIP CODE \ 431 2200 8. Treasurer: List the name and address (phone number ~ optional) of the treasurer of the committee; and the name and address of any designated agent (e.g., assistant treasurer). Full Name OfTreasurer Mailing Address Ron Carver 1205 Prospect Street Takoma Park Title or Position V Treasurer CITYA MD STATEA 301 20912 - ZIP CODE 4 431 2200 Telephone number FEC Form 1 (Revised 02/2009) Full Name of Designated Agent Page 4 Mailing Address Title or Position V CITYA STATE A ZIP CODE A Telephone number 0 tn 0 HI 9. Banks or Other Depositories: List all banks or other depositories in which the committee deposits funds, holds accounts, rents safety deposit boxes or maintains funds. Name of Bank, Depository, etc. Wells Fargo Bank J I I I I I L 1175 Unlvereity Blvd I I I I I I I I I I I I I I I I I I I I I \ I I I \ I I I I I I I I I I I I I I l l l l I I I I I I I I I l I l I l J I l I I l l Mailing Address L_J Talfoipa.F^ric, CITY Name of Bank, Depository, etc. I I I I I I I I I I I I I I I I I I I I I I I UfDI STATED I , ,299^21- I L ZIPCODE A I I I I I I I I I I I I I I I I 1 I I I I I I I I I I I I I I I I l l I I l I I l I I l I I I l ' Mailing Address I I I I I I I I I I I I I I I I I CiTY A [_! I STATEA |_J I i I I -1 ZIP CODE A I 1_ _L Federal Election Commission ENVELOPE REPLACEMENT PAGE FOR INCOMING DOCUMENTS The FEC added this page to the end of this filing to indicate how it was received. Date of Receipt o o Hand Delivered Postmarked USPS First Class Mail Postmarked (R/C) USPS Registered/Certified Postmarked I I USPS Priority Mail Delivery Confirmation(TM) or Signature Confirmation(TM)" Label I Postmarked I I I I USPS Express Mail I Postmark Illegible No Postmark Shipping Date I Ovemight Delivery Service (Specify): Next Business Day Delivery I I o I I I I I I Received from House Records & Registration Office I Received from Senate Public Records Office I Received from Electronic Filing Office I Other (Specify): Date of Receipt Date of Receipt Date of Receipt Date of Receipt or Postmarked PREPARER (/05 320) DATE PREPARED