r n FEC Form 1 (Revised 02/2009) Page 2 5, TYPE OF COMMITTEE Candidate Committee: (a) X This committee is a principal campaign committee. (Complete the candidate information below.) (b) This committee is an authorized committee, and is NOT a principal campaign committee. (Compiete the candidate information below.) Candidate |H)ll3ry,Rpdhapi,qiiintpri III Candidate Office State cz Party Affiliation Sought; House Senate a President District 5 (C) This committee supports/opposes only one candidate, and is NOT an authorized committee. 0 Name of 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 Candidate 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 Party Committee: I (National, State (Democratic, (d) This committee is a or subordinate) committee of the nn 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: Corporation I Corporation w/o Capital Stock Latjor Organization Membership Organization |_| Trade Association Cooperative In addition, this committee is a Lobbyist/Registrant PAC. (f) This committee supports/opposes more than one Federal candidate, and is NOT a separate segregated fund or party — committee, (i.e., nonconnected committee) 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) 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. (h) 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. M FEC ID numberlQ 2. J FEC ID number|Qi 3. J FEC ID number^ 4. J FEC ID numberlQ L J