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. WILLIAM A DOMBI

Employer Name:

NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE

Identification Numbers

House Registrant ID:

32599

Senate Registrant ID:

26570

Reporting Period

Year:

2011

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:

$1,000.00

Date:

03/22/2011

Payee:

Home Care & Hospice PAC

Honoree:

Home Care & Hospice PAC

#2.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

03/30/2011

Payee:

Bill Nelson for Senate

Honoree:

Bill Nelson

#3.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

03/31/2011

Payee:

Hatch for Senate

Honoree:

Orrin Hatch

#4.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

03/31/2011

Payee:

Friends of Maria

Honoree:

Maria Cantwell

#5.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$250.00

Date:

06/30/2011

Payee:

Courtney for Congress

Honoree:

Joe Courtney

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:

WILLIAM DOMBI, 1/31/2012 11:24:00 AM