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RtXEWED January 19,2012 Federal Election Commission 999 E Street,NW Washington,DC 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. Treasure Damian C. Palmer and Jack C. Pilgrim for a Better America Super PAC RECEIVEO r STATEMENT OF 2012 JAN 25 AM 8:57 ORGANIZATION FEC FEC MAIL CENTER FORIVI 1 1. NAME OF f'~'f, (Check if name Example: If typing, type 12FE4M5 COMMITTEE (in full) ' ..i is changed) over the lines. iC*i iPint/igiri?i/n I'TioiO lD<\ifflif ia.ifti iCoi imig^iCi i<^!/^i<}i IQ iBi&ilili^.iPi lAihi-girii i^iai iSitiij)ie.r, iPiACi I I I I I ADDRESS (number and street) i I I I I (Check if address I I I! ! I i ! I I l ll 1 I I I i is changed) l^ipiP Ii^i^!-fnifi>i/i4 CITY STATE ZIP CODE COMMITTEE'S E-MAIL ADDRESS (Please provide only one e-mail address) IDAI^N iai/i!piAil^i/y)i/>jri€)/;i^iAi.iDioi/yi I l l ii (Check if address is changed) i I 1 I I I I COMMITTEE'S WEB PAGE ADDRESS (URL) lA^/iAi I I I I II I I I I -LJ. M l l l ll (Check if address is changed) I I I !! l i l il 2. DATE :0 I 15: A C \ % 3. FEC IDENTIFICATION NUMBER 4. IS THIS STATEMENT NEW (N) OR 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 D fct / o a / Y •• Y • V V Signature of Treasurer Date NOTE: Submission of false, erroneous, or incomplete information 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 For further information contact: FEC FORIVI 1 L Use Federal Election Commission Toll Free 800-424-9530 (Revised 02/2009) | Only Local 202-694-1100 r 1 FEC Form 1 (Revised 02/2009) Page 2 5. TYPE OF COMMITTEE Candidate Committee: (a) This committee is a principal campaign committee. (Complete the candidate information below.) (b) ' Ji This committee is an authorized committee, and is NOT a principal campaign committee. (Complete the candidate information below.) Name of Candidate I l ll I l ll J L l l l l ll Candidate Office State Party Affiliation Sought: House Senate President District (c) This committee supports/opposes only one candidate, and is NOT an authorized committee. Name of I I ! i I I I I I Candidate i_J L Party Committee: (National, State (Democratic, (d) This committee is a or subordinate) committee of the 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 Corporation w/o Capital Stock Labor 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 'Lii 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. Connmittees Participating In Joint Fundraiser 1. I [ I I I I J FEC ID number Q 2. I I I I II j j FEC ID number. Q i i 3- IIIII I j I FEC ID number Q. 4. l l l l ll I I FEC ID number Q L J r FEC Form 1 (Revised 02/2009) Page 3 Write or Type Committee Name 6. Name of Any Connected Organization, Affiliated Committee, Joint Fundraising Representative, or Leadership PAC Sponsor iSolnl^l lolnldi iftaioiai/illi^risi lO-fi iLhke^rh^. I I I M I I I I I I I I I I I II I I I I I I I I I I II Mailing Address CITY STATE ZIP CODE Relationship: !i)C.Connected Organization :•; Affiliated Committee ; 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 Name I I I i I Mailing Address iPi^i iBi^i^^i it i ! I I ! l i l l l l ll I I I I ! i I I I i l l !! iSipiFil ifli^rPiMtVi/ irl Title or Position CITY STATE ZIP CODE lA,-gi5i rig>i'^iAi/li'^i rrr'iAi,4i6iUilPie>!p l Telephone number [MiJLl3" t Z i M j " \^ S'Sl^l 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 ^ K /* f ' / * of Treasurer OiQ.iC^/?i iV^^i i fi I it^igif ili/Wi l i l il J L_L Mailing Address' I I I ! ! i I • I 1 I I i l i! * 0 CITY STATE ZIP CODE Title or Position rfri^j^i i^iUi^iftin I I I i i i I I I I i Telephone number J L r FEC Form 1 (Revised 02/2009) Page 4 Full Name of IPicL'/nm^i/ii i^ff' \F\<!i\irr\\£'^\ Agent l l l l ll I I I I i I I |P6, lfi,dlXl ,f),L,,\A: Mailing Address I l l ii l l l l l l! i I j i I I I I I II I ' ll ! I I CITY STATE ZIP CODE Title or Position Ij^ifi/l ll 5 ifidi^ifi \T{'\4LCi\^\[S\(^^.\^i I Telephone number iVi \\'^\-\7M3\-\^\3\3P{\ 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. lljdidrnQiAi^i iBig'^i^^i J L_i L__L l i l l l l ll Mailing Address * I^K^i^iri iSi> i i6iL i^/^i^i-AiiS-i^igi lAt/i^i ^ I i I I i ' I I I I ' I I l ii I i ! I I I ! I I I I l^fliC i i i i i ii CITY STATE ZIP CODE Name of Bank, Depository, etc. i I 1 i I I L_L I I 1 I I I II Mailing Address I I ! _L_i jl l i t! I I I I I II I i li 1^ > ! ! ! !> i I I CITY STATE ZIP CODE L J 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 Hand Delivered Postmarked USPS First Class Mail Postmarked (R/C) [ I USPS Registered/Certified Postmarked I I USPS Priority Mail Delivery Confirmation™ or Signature Confirmation™ Label I I Postmarked I I USPS Express Mall [ I Postmark illegible • No Postmark Shipping Date I I Ovemight Delivery Service (Specify): Next Business Day Delivery I I Date of Receipt I I Received from House Records & Registration Office Date of Receipt • Received from Senate Public Records Office Date of Receipt [ I Received from Electronic Filing Office Date of Receipt or Postmarked I I Other (Specify): PREPARER DATE PREPARED (3/2005)

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Preview Damian C Palmer And Jack C Pilgrim For A Better America Super Pac

RtXEWED January 19,2012 Federal Election Commission 999 E Street,NW Washington,DC 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. Treasure Damian C. Palmer and Jack C. Pilgrim for a Better America Super PAC RECEIVEO r STATEMENT OF 2012 JAN 25 AM 8:57 ORGANIZATION FEC FEC MAIL CENTER FORIVI 1 1. NAME OF f'~'f, (Check if name Example: If typing, type 12FE4M5 COMMITTEE (in full) ' ..i is changed) over the lines. iC*i iPint/igiri?i/n I'TioiO lD<\ifflif ia.ifti iCoi imig^iCi i<^!/^i<}i IQ iBi&ilili^.iPi lAihi-girii i^iai iSitiij)ie.r, iPiACi I I I I I ADDRESS (number and street) i I I I I (Check if address I I I! ! I i ! I I l ll 1 I I I i is changed) l^ipiP Ii^i^!-fnifi>i/i4 CITY STATE ZIP CODE COMMITTEE'S E-MAIL ADDRESS (Please provide only one e-mail address) IDAI^N iai/i!piAil^i/y)i/>jri€)/;i^iAi.iDioi/yi I l l ii (Check if address is changed) i I 1 I I I I COMMITTEE'S WEB PAGE ADDRESS (URL) lA^/iAi I I I I II I I I I -LJ. M l l l ll (Check if address is changed) I I I !! l i l il 2. DATE :0 I 15: A C \ % 3. FEC IDENTIFICATION NUMBER 4. IS THIS STATEMENT NEW (N) OR 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 D fct / o a / Y •• Y • V V Signature of Treasurer Date NOTE: Submission of false, erroneous, or incomplete information 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 For further information contact: FEC FORIVI 1 L Use Federal Election Commission Toll Free 800-424-9530 (Revised 02/2009) | Only Local 202-694-1100 r 1 FEC Form 1 (Revised 02/2009) Page 2 5. TYPE OF COMMITTEE Candidate Committee: (a) This committee is a principal campaign committee. (Complete the candidate information below.) (b) ' Ji This committee is an authorized committee, and is NOT a principal campaign committee. (Complete the candidate information below.) Name of Candidate I l ll I l ll J L l l l l ll Candidate Office State Party Affiliation Sought: House Senate President District (c) This committee supports/opposes only one candidate, and is NOT an authorized committee. Name of I I ! i I I I I I Candidate i_J L Party Committee: (National, State (Democratic, (d) This committee is a or subordinate) committee of the 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 Corporation w/o Capital Stock Labor 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 'Lii 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. Connmittees Participating In Joint Fundraiser 1. I [ I I I I J FEC ID number Q 2. I I I I II j j FEC ID number. Q i i 3- IIIII I j I FEC ID number Q. 4. l l l l ll I I FEC ID number Q L J r FEC Form 1 (Revised 02/2009) Page 3 Write or Type Committee Name 6. Name of Any Connected Organization, Affiliated Committee, Joint Fundraising Representative, or Leadership PAC Sponsor iSolnl^l lolnldi iftaioiai/illi^risi lO-fi iLhke^rh^. I I I M I I I I I I I I I I I II I I I I I I I I I I II Mailing Address CITY STATE ZIP CODE Relationship: !i)C.Connected Organization :•; Affiliated Committee ; 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 Name I I I i I Mailing Address iPi^i iBi^i^^i it i ! I I ! l i l l l l ll I I I I ! i I I I i l l !! iSipiFil ifli^rPiMtVi/ irl Title or Position CITY STATE ZIP CODE lA,-gi5i rig>i'^iAi/li'^i rrr'iAi,4i6iUilPie>!p l Telephone number [MiJLl3" t Z i M j " \^ S'Sl^l 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 ^ K /* f ' / * of Treasurer OiQ.iC^/?i iV^^i i fi I it^igif ili/Wi l i l il J L_L Mailing Address' I I I ! ! i I • I 1 I I i l i! * 0 CITY STATE ZIP CODE Title or Position rfri^j^i i^iUi^iftin I I I i i i I I I I i Telephone number J L r FEC Form 1 (Revised 02/2009) Page 4 Full Name of IPicL'/nm^i/ii i^ff' \F\<!i\irr\\£'^\ Agent l l l l ll I I I I i I I |P6, lfi,dlXl ,f),L,,\A: Mailing Address I l l ii l l l l l l! i I j i I I I I I II I ' ll ! I I CITY STATE ZIP CODE Title or Position Ij^ifi/l ll 5 ifidi^ifi \T{'\4LCi\^\[S\(^^.\^i I Telephone number iVi \\'^\-\7M3\-\^\3\3P{\ 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. lljdidrnQiAi^i iBig'^i^^i J L_i L__L l i l l l l ll Mailing Address * I^K^i^iri iSi> i i6iL i^/^i^i-AiiS-i^igi lAt/i^i ^ I i I I i ' I I I I ' I I l ii I i ! I I I ! I I I I l^fliC i i i i i ii CITY STATE ZIP CODE Name of Bank, Depository, etc. i I 1 i I I L_L I I 1 I I I II Mailing Address I I ! _L_i jl l i t! I I I I I II I i li 1^ > ! ! ! !> i I I CITY STATE ZIP CODE L J 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 Hand Delivered Postmarked USPS First Class Mail Postmarked (R/C) [ I USPS Registered/Certified Postmarked I I USPS Priority Mail Delivery Confirmation™ or Signature Confirmation™ Label I I Postmarked I I USPS Express Mall [ I Postmark illegible • No Postmark Shipping Date I I Ovemight Delivery Service (Specify): Next Business Day Delivery I I Date of Receipt I I Received from House Records & Registration Office Date of Receipt • Received from Senate Public Records Office Date of Receipt [ I Received from Electronic Filing Office Date of Receipt or Postmarked I I Other (Specify): PREPARER DATE PREPARED (3/2005)

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