FEC M/\iL CSTER Z IJ L 1 Still.-1.2 OU 2 Committee Name: Fhe Government Integrity Fund ~ Action Network If registered, FEC ID: Today's Date: July 11,2011 Federal Election Commission 999 E Street, N.W. Washington, D.C. 20463 Re: Form 1, Statement of Organization--Unlimited Contributions To Whom It May Concern: 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, Treasurer's Name: Wi 1 iam M. Todd 1 , Treasurer RECr-"n FEC MAIL CEiJES r FEC FORM 1 1. NAMEOF COMMITTEE (in full) STATEIMENT OF ORGANIZATION 2!liJULi2 flii 11:1,2 n Office Use Only o I I I (Check if name is changed) Example: If typing, type over the lines. |l2FE4M5 fhje ,G9V|erpn;iept,ln|tegr^ty,F^n|d -- if\qtiqn .N^tyvgrk, 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 o l l l l l l l I ADDRESS (number and street) I I I I I I I I I I I I I |iq7,E^st^t^te,SfrQe^ o (Check if address is changed) I I I I I I I I I I I IIIIIIIIIII I p9lHm|bi|s l l l l l l l CITY STATE ZIP CODE COMMITTEE'S E-MAIL ADDRESS (Please provide only one e-mail address) n (Che* H address Mocjd@p)^lrOfloMp.(pOri | i I I I I l l I I I I I I I I I I I I I I I I I l l I l I l I I I is changed) -- COMMITTEE'S WEB PAGE ADDRESS (URL) (Check if address is changed) 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 o I I I I I I I I 2 DATE 3. Q 7 ^ gQiL FEC IDENTIFICATION NUMBER 4. IS THIS STATEMENT NEW (N) OR I I AMENDED (A) / certify that I have examined this Statement and to the best of my knowledge and belief it is true, correct and complete. Type or Print Name of Treasurer William M. Todd Signature of Treasurer Date { n J F20J.1 NOTE: Submission of false, 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 furlher infbrmation contact: Federal Election Commission Toll Ree 800-424-9530 Local 202-694-1100 L FEC FORM 1 (Revised 02/2009) | r 5. FEC Form 1 (Revised 02/2009) TYPE OF COMMITTEE Page 2 Candidate Committee: () a (b) o This committee is a principal campaign committee. (Complete the candidate information below.) This committee is an authorized committee, and is NOT a principal campaign committee. (Complete the candidate information below.) I I I I I I I I Office Sought: I I ' o Name of Candidate Candidate Party Affiliation o I I I House o I I I 1 I I Senate o I I I I I I I I State President District (c) o This committee supports/opposes only one candidate, and is NOT an authorized committee. 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 I I I I I I I Name of Candidate Party Committee: (d) This committee is a (National, State or subordinate) committee of the ij----^---ij il ,, ^ J (Democratic, (uemocratic, Republican, etc.) Party Political Action Committee (PAC): (e) This committee is a separate segregated fund. (Identify connected organization on line 6.) Its connected organization is a: I I I I \ (f) I--I Corporation Membership Organization I Corporation w/o Capital Stock Trade Association ^] ^] Labor Organization Cooperative In addition, this committee is a Lobbyist/Registrant PAC. This committee supports/opposes more than one Federal candidate, and is NOT a separate segregated fund or party committee, (i.e., nnnrnnnprtoH committee) m m m l t t p p d A nonconnected mmmittep^ In addition, this committee is a Lobbyist/Registrant PAC. In addition, this committee is a Leadership PAC. (Identify sponsor on line 6.) Joint Fundraising Representative: (g) (h) o o 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 federal 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 --Li U U U L tJ- 1. 23- IIIIII I I I I II I I I I I II Ill II M l J FEC ID number I FEC ID numt)er n r FEC ID numljer FEC ID number \Cy>. 4. I I I I I I I I I I I I I I I L J r 6. FEC Form 1 (Revised 02/2009) Page 3 Write or Type Committee Name The Government Integrity Fund - Action Network Name of Any Connected Organization, Affiiiated Committee, Joint Fundraising Representative, or Leadership PAC Sponsor Mailing Address CITY Relationship: j^Connected Organization | [Affiliated Committee | STATE ZIP CODE [joint Fundraising Representative ^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 N m ae Mailing Address |W/lli^r^ iyi.|T9d(;i , , I | 1 ^ 7 , E ^ S j t ^ t ^ t Q Sjtr^O^ 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 i i l i i , i i i i i i i i i i I i I I I I I I I I I I Title or Position CITY STATE ZIP CODE |Tr,e^sirir9r 8. I I I I I I I I I I I I Telephone number 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). S'lreiurer Mailing Address ^ V j H W ^.,T