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FEe FORM 2
STATEMENT OF CANDIDACY
1. (a) Name of Candidate (in full)

2011 JUN 13 PM 4: 12

Michele Bachmann
(b) Address (number and street)

D Check if address changed

2. Candidate's

FEC Identification

Number

P. O. Box 251310
(c) City, State, and ZIP Code

3.
5. Office Sought

Is This Statement •

New (N) OR

Amended (A)

Woodbury, MN 55125
4. Party Affiliation

6. State & District of Candidate

Republican

U.S. President DESIGNATION

n/a

OF PRINCIPAL CAMPAIGN COMMITTEE
as my Principal Campaign Committee for the

7.

I hereby designate

the following should (in full)

named political

committee

2012
(year of election)

election(s).

NOTE: This designation

be filed with the appropriate

office listed in the instructions.

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(a) Name of Committee

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Bachmann for President
(b) Address (number and street)

P. O. Box 251310
(c) City, State, and ZIP Code

Woodbury, MN 55125

DESIGNATION
8. I hereby authorize candidacy. NOTE: This designation (a) Name of Committee the following named committee,

OF OTHER AUTHORIZED
Joint Fundraising Representatives) campaign which is NOT my principal

COMMITTEES
to receive and expend funds on behalf of my

(Including

committee,

should be filed with the principal (in full)

campaign

committee.

None
(b) Address (number and street)

(c) City, State, and ZIP Code

?, :WII
NOTE: Submission of false, erroneous, or incomplete information may subject the person signi
FEe FORM 2 (REV. 0212009)

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.

[2(Hand Delivered

~/13JII

Date of Receipt

0 USPS First Class Mail 0
USPS Registered/Certified

Postmarked

Postmarked (R/C)

0 USPS Priority Mail 0
USPS Express Mail

Postmarked

Delivery Confirmation ™ or Signature Confirmation™ Label Postmarked

D

0 Postmark Illegible

o o o

0 No Postmark
Shipping Date Overnight Delivery Service (Specify): Next Business Day Delivery

D

D

Date of Receipt Received from House Records & Registration Office Date of Receipt Received from Senate Public Records Office Date of Receipt Received from Electronic Filing Office Date of Receipt or Postmarked

D Other (Specify):
P~ RER (3/2005)

fpjt¢//f
DATE PREPARED

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CENTEH

2011 JUN 13 PH 4: II

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1.

FORM 1
NAME OF COMMITTEE (in full)

FEe

STATEMENT OF ORGANIZATION
(Check if name is changed) Example:lf typing, type over the lines.

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ADDRESS

(number and street)

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(Check if address is changed)

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CITY

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STATE

15151112151-1 ZIP CODE

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COMMITTEE'S

E-MAIL ADDRESS (Please provide only one e-mail address)

(Check if address is changed)

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COMMITTEE'S

WEB PAGE ADDRESS

(URL)

(Check if address is changed)

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2.

DATE

3.

FEC IDENTIFICATION

NUMBER

4.

IS THIS STATEMENT

NEW (N)

OR

AMENDED

(A)

I 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

Nancy H. Watkins

Signature of Treasurer

Date

o

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6

o

8

2

0

1

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 Use Only
For further information contact: Federa' Election Commission Toll Free 800-424-9530 Local 202-694-1100

L

FEe FORM 1
(Revised 0212009)

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5. (a) (b)

FEC Form 1 (Revised 0212009) OF COMMllTEE

Page 2

TYPE

Candidate Committee:
This committee This committee information Name of Candidate Candidate Party Affiliation Office Sought: State House Senate President District (c) This committee supports/opposes only one candidate, and is NOT an authorized committee. is a principal campaign committee. (Complete the candidate is an authorized committee, information below.)

and is NOT a principal campaign committee. (Complete the candidate

below.)

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N'l
(~.)

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Name of Candidate

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Party Committee:
(d) This committee is a (National, State or subordinate) committee of the (Democratic, 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 Membership Organization Corporation w/o Capital Stock Labor Organization Cooperative

Trade Association PAC.

In addition, this committee is a Lobbyist/Registrant (f)

This committee supports/opposes more than one Federal candidate, committee. (Le., nonconnected committee) In addition, this committee is a Lobbyist/Registrant PAC.

and is NOT a separate segregated fund or party

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. 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.

(h)

Committees 1.

Participating

in Joint Fundraiser

!,_I .L_I ..L.I ..L...I.J....I...l..1-1.1....J1-"--1 I!,_ .L_I ..L.I ..L...I.J.......l..1 -1.1....J1-"--1 L-I 1..-1..L.I ..1-1-1-1 ....I-1-1..1_..1-"--1 IL-l..-I J.._I ..1-1-1-1 ....1-1I.I_..I--,--I -

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FEC 1

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2.
3. 4.

FEC 1

FEC 10 number FEC 10 num ber

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6.

FEC Form 1 (Revised 0212009) Name

Page 3

Write or Type Committee

Bachmann for President
Name of Any Connected Organization, Affiliated Committee, Joint Fundraising Representative, or Leadership PAC Sponsor

IN

1 InIeI 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
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Mailing Address

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Relationship:

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CITY

STATE

ZIP CODE

Connected Organization

r"~Affiliated

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Committee

Fundraising Representative

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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 Mailing Address

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,

Title or Position

CITY

STATE

ZIP CODE

Telephone number

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1!

31_ I 2 ! 5 I 41_1 3 I 3!

6!

91

8.

Treasurer: List the name and address (phone number _. optional) of the treasurer of the committee; any designated agent (e.g., assistant treasurer). Full Name of Treasurer Mailing Address

and the name and address of

1

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CITY Title or Position STATE

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Telephone number

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41-1

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91

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FEC Form 1 (Revised 02/2009)

Page 4

Full Name of Designated Agent Mailing Address

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CITY Title or Position

STATE

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Telephone number

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41_1 3 I 3 I 6! 91

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9.

Banks or Other Depositories: List all banks or other depositories safety deposit boxes or maintains funds. Name of Bank, Depository, etc.

in which the committee

deposits funds, holds accounts, rents

(~)

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Mailing Address

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CITY Name of Bank, Depository, etc.

STATE

ZIP CODE

Mailing Address

I(,((,

CITY

STATE

ZIP CODE

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_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 ~and Delivered

u/J3jJl
Postmarked Postmarked (RIC)

D D

USPS First Class Mail

D USPS RegisteredlCertified
USPS Priority Mail

Postmarked

Delivery Confirmation ™ or Signature Confirmation ™ Label

D

D USPS Express Mail D Postmark
Illegible

Postmarked

D No Postmark D Overnight Delivery Service (Specify): D D
Received from House Records & Registration Office

Shipping Date

Next Business Day Delivery

D

Date of Receipt

Date of Receipt Received from Senate Public Records Office Date of Receipt Filing Office Date of Receipt or Postmarked Other (Specify):

o

D Received from Electronic

b/J<Jjll
PR~RER (3/2005) DATE PREPARED

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