FEC Form 2 for Report FEC-748493FEC Form 2 for Report FEC-748493

FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-748493

1. MICHAEL GRIMM

560 9TH STREET
BROOKLYN, NY 11215

2. Identification Number: H0NY13074

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: New York - 13

DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE

7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2012 election(s).

MICHAEL GRIMM FOR CONGRESS
FEC ID #: C00470807

PO Box 270
STATEN ISLAND, NY 10310

DESIGNATION OF OTHER AUTHORIZED COMMITTEES

8. I hereby designate the following named committee, which is NOT my principal campaign committee, to receive and expend funds on behalf of my candidacy.

TEAM 2012
FEC ID #: C00493817

228 S WASHINGTON ST STE 115
ALEXANDRIA, VA 22314

PATRIOT DAY II 2011
FEC ID #: C00502252

228 S WASHINGTON ST STE 115
ALEXANDRIA, VA 22314

DECLARATION OF INTENT TO EXPEND PERSONAL FUNDS (House or Senate Only)

9. I intend to expend personal funds exceeding the threshold amount (see 11 C.F.R. 400.9) by

9A. 0.00 for the primary election, and
9B. 0.00 for the general election

Signed as: MICHAEL GRIMM
Signed by the candidate on: 10/14/2011

Filed: 10/14/2011

(End FEC FORM 2)

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