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. DAVE LARSON

Employer Name:

American Capitol Group

Identification Numbers

House Registrant ID:

36550

Senate Registrant ID:

305852

Reporting Period

Year:

2009

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:

$500.00

Date:

10/15/2009

Payee:

Tom Rooney for Congress

Honoree:

Congressman Tom Rooney

#2.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$2,000.00

Date:

12/16/2009

Payee:

Bob Corker for Senate

Honoree:

US Senator Bob Corker

#3.

Contribution Type:

FECA

Contributor Name:

Self

Amount:

$500.00

Date:

12/16/2009

Payee:

Pat Roberts Victory Committee

Honoree:

US Senator Pat Roberts

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:

DAVE LARSON, 1/6/2010 10:52:29 AM