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FEC Disclosure Form 1M for DOMINO'S PIZZA LLC POLITICAL ACTION COMMITTEEForm 1M for DOMINO'S PIZZA LLC POLITICAL ACTION COMMITTEE

FEC FORM 1M

NOTIFICATION OF MULTICANDIDATE STATUS

FILING FEC-131525


1. DOMINO'S PIZZA LLC POLITICAL ACTION COMMITTEE

30 FRANK LLOYD WRIGHT DRIVE
ANN ARBOR, MI 48106

2. FEC Committee ID #: C00366088

3. This is NOT a state party committee

4. STATUS BY AFFILIATION:

The committee submitted its Statement of Organization (FEC FORM 1)
on ________________________ and simultaneously qualified as a multicandidate committee through its
affiliation with:

Committee Name: ________________________
FEC Identification Number: _______________________

5. STATUS BY QUALIFICATION:

(a) Candidates: The committee has made contributions to the five federal candidates listed below:


NameOffice SoughtState/DistrictDate
(i) Mike Rogers
House of Representatives
Michigan/08
06/13/2001
(ii) Candice Miller
House of Representatives
Michigan/10
10/14/2002
(iii) Christopher Cox
House of Representatives
California/48
10/14/2002
(iv) Dave Camp
House of Representatives
Michigan/04
10/14/2002
(v) J Dennis Hastert
House of Representatives
Illinois/14
10/14/2002

(b) Contributors: The committee received a contribution from its 51st contributor on: 01/21/2003

(c) Registration: The committee has been registered for at least 6 months. FEC FORM 1 was submitted on: 04/30/2001

(d) Qualification: The committee met the above requirements on: 01/01/2003

Treasurer: JEFFREY D. LAWRENCE
Date Signed: 08/18/2004

(End FEC FORM 1M)


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