RECEIVED

r STATEMENT OF FEC MWL CEHTER

FEC
FORM 1 ORGANIZATION
Office Use O n l ^

1. NAME OF (Check if name

COMfVIITTEE (in full) is changed) over ine lines. lw»>araassiWiB^!WmWa^^^

I Pawlenty f o r P r e s i d e n t E x p l o r a t o r y Committee
I I I ! I I I I I I I I I M I I I r I I I I j I I 1 I I

L l i l l l i l l I I I I I

I One F i n a n c i a l P l a z a , 120 South S i x t h S t r e e t , 9 t h F l o o r

ADDRESS (number and street)
I I I I I j- I I J_J • I I I I I I ! I I I I I I

["11 (Check if address L. I I I I I I

i-^Jl Is changed) MN 55402
[ Mir^neayolis
I I I I I

CITY STATE ZIP CODE

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

I info@timpawlenty.com
^ i ! I I T I ! I ^1 I I I I I I I I i i I I i I I I I
(Check if address
Ikl is changed)
I I I I I I I I I I I I ! I

COMMITTEE'S WEB PAGE ADDRESS (URL)

I www.t:irnpawlentjy, com
I I I I I I I
(Check if address
y is changed)
I I i I I I I
I I i I I I i

2. DATE I 03 I I 18 I j 2011 1

3. F E C IDENTIFICATION NUMBER

4. i s THIS STATEMENT ix| NEW (N) OR j AMENDED (A)

/ certify that I have examined this Statement and to the best of my knowledge and belief it is true, correct and complete.

Mark Kennedy
Type or Print Name of Treasurer

Signature of Treasurer Date I 03 I ! 18 I ' | 2011 _ |

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:

Use Federal Election Commission FEC FORM 1
L Only
Toll Free 800-424-9530
Local 202-694-1100
(Revised 02/2009) |
r FEC Form 1 (Revised 02/2009) Page 2

5. T Y P E OF COMMITTEE
Candidate Committee:
(a) ^X;'I This committee is a principal campaign committee. (Complete the candidate information below.)

(b) This committee is an authorized committee, and is NOT a principal campaign committee. (Complete the candidate
information below.)
Name of Timothy Pawlenty
Candidate I I i I i I
I I I I I I I I I I I I I I I i I I
Sa:5i3:i|;..-:H:'

Candidate Office state

Party Affiliation Sought: House |j Senate President
District

(c) [[J This committee supports/opposes only one candidate, and is NOT an authorized committee.

Name of
I I I I I l i l l l i l l I 1 I I I I I I I I I I
Candidate I I I I I I I I I I I II I I i
Party Committee:
(National, State (Democratic,
(d) LJ committee is a or subordinate) committee of the Republican, etc.) Party.

Political Action Committee (PAC):

(e) I This committee is a separate segregated fund. (Identify connected organization on line 6.) Its connected organization is a:

Corporation 1^ Corporation w/o Capital Stock Labor Organization

Membership Organization 1^ Trade Association Cooperative

1^ I In addition, this committee is a Lobbyist/Registrant PAC.

(0 PI This committee supports/opposes more than one Federal candidate, and is NOT a separate segregated fund or party
committee, (i.e., nonconnected committee)

|jj In addition, this committee is a Lobbyist/Registrant PAC.

ijl 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) [f^ This committee collects contributions, pays fundraising expenses and disburses net proceeds for two or more political
I J committees/organizations, none of which is an authorized committee of a federal candidate.

Committees Participating in Joint Fundraiser

1. I I I I I I I I I I ! i M I J FEC ID number I Q p

2. FEC ID number|QM

3. I FEC ID number 1 0

4. j FEC ID number 1 0 ^

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

Mailing Address

I I I L—l"l I I I
CITY STATE ZIP CODE

Relationship: | | Connected Organization ?^ |Affiliated Committee |^ | Joint Fundraising Representative | j | 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.

I Gregg Peterson
Full Name I I 1^^ I I I I I I I I I l l l l l l l l l

Mailing Address

I I I I I I I I I I I I I I I I I l l

I M|in|nejai^o:^ I S
I I I I I I I I -L_L

Title or Position CITY STATE ZIP CODE

I ^s^i^t^ntp yreapupr^r I I I I I I I I J Telephone number I i i i -1 i i I~ L I I I

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 ^^^^ Kennedy

of Treasurer I i i i i i i i i i i I I I I I I I I I I I I

Mailing Address
qn^ ?i?aipcfa^ pi,a2^a,, 2^2(f ^optfi ,S^xt^h ,St^r^e^, , 9y:h, F.lqoi^ , , , ,

I I I I I I I I I I I I I I I
I N|inn^ayojLip
I I I 11 I I I 11 I m i^i^w • i-i I I, I

Title or Position CITY STATE ZIP CODE

Treasurer
I l l l l l l l l l
I I I Telephone number I i i I -1 i i I~ I i i i I
L J
 r FEC Form 1 (Revised 02/2009) Page 4
n
Full Name of
Designated i r D i- I
Agent I ^ F ^ ^ ^ t|et^eips9n i i i i i i i i I

Mailing Address | qnq ^ii^ai^cia;! pi,a2;a,, 1^2? ^opt)i ^:^xt^h ,St^r^e^, , 9|:h, F,lqoi^ , 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 ^^ir^n^ago;i^ | | | | 5,5402 , |-| . , , |

CITY STATE ZIP CODE
Title or Position
0£?
I Aps,i^t^ntp l-r^apuprepr , , , , , , , , , | Telephone number I i i I -1 i i I -1 • • . I

qr]! 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.

Wells Fargo Bank

I I I I I I I I I I I ' I I I ' I l l I

Mailing Address I "^190,0 i^^ryep fiv,en,u^ ^o^tl^

I I I I I I I I I I I I I I I I I ' I I

I I l l I I
I Blc^oiningtpo^ | | M|J | | 55431 , | - | , , ,

CITY STATE ZIP CODE

Name of Bank, Depository, etc.

BB&T
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

Mailing Address I ^.Oq ^oytl^ ^aph^r^gt^or^ ^tye^t 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 l l l l l l l l l

Alexandria i I VA I | 22314 i i
I I I T I I I I I I I I I I I I I I I T I I I I I I l-l 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
s/zi/it
Postmarked
USPS First Class Mail

Postmarked (R/C)
USPS Registered/Certified

Postmarked
USPS Priority Mail

Delivery Confirmation™ or Signature Confirmation™ Label |

Postmarked
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Postmark Illegible

No Postmark

Shipping Date
Overnight Delivery Service (Specify):

Next Business Day Delivery

Date of Receipt
Received from House Records & Registration Office

Date of Receipt
Received from Senate Public Records Office

Date of Receipt
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Date of Receipt or Postmarked

Other (Specify):

0^ 3/zf/l/
PREPARER DATE PREPARED
(3/2005)