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Lobbyist Reporting Form

Please complete the PDF version of this form and sign before a notary. You will scan this report and submit it online via the below electronic filing format.

Lobbying Activities Report


Note: All uploads on this form must be no bigger than 5MB.

Lobbyist Information

I. Business Arrangements

Please report the extent of any direct business arrangement or partnership with any candidate for public office or any official in the legislative or executive branch.




Allowed extensions: .pdf, .doc, .docx, .xls, .xlsx
II. Gifts Extended to Legislative Branch

A. Please provide an itemized list by date, beneficiary, amount and circumstance of each gift of fifty dollars ($50) or more by you or anyone acting at your direction to benefit an official in the legislative branch, a member of an official’s staff or immediate family, or a campaign or testimonial committee established for the benefit of an official in the legislative branch.




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B. Please report any cumulative total of more than fifty dollars ($50) in a single week to benefit an official in the legislative branch.




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C. Please provide an itemized list by date, beneficiary, amount and circumstance of transactions, gifts, or expenditures with a cumulative total of more than five hundred dollars ($500) by you or anyone acting at your direction to benefit an official in the legislative branch.




Allowed extensions: .pdf, .doc, .docx, .xls, .xlsx
III. Gifts Extended to Executive Branch

Please provide an itemized list by date, beneficiary, amount and circumstance of each gift of twenty-five dollars ($25) or more made by you or anyone acting at your direction to benefit an official in the executive branch, a member of an official’s staff or immediate family, or a campaign or testimonial committee established for the benefit of such official.




Allowed extensions: .pdf, .doc, .docx, .xls, .xlsx
IV. Gifts Extended to Candidates for Public Office

Please provide an itemized list by date, beneficiary, amount and circumstance of each gift of fifty dollars ($50) or more by your or anyone acting at your direction to benefit a candidate for public office, a member of a candidate’s staff or immediate family, or a campaign or testimonial committee established for the benefit of a candidate for public office.




Allowed extensions: .pdf, .doc, .docx, .xls, .xlsx
V. Political Contributions

Please provide an itemized list by date, beneficiary and amount of each political contribution of more than one hundred dollars ($100) made by you or anyone acting at your direction to benefit a candidate for public office, an official in the legislative branch or executive branch, a member of the candidate or official’s staff or immediate family, or a campaign committee or testimonial committee established for the benefit of a candidate for public office or such official.




Allowed extensions: .pdf, .doc, .docx, .xls, .xlsx
Completed Lobbyist Activities Report

The scanned notarized version of the above report must be uploaded in order for your report to be accepted for filing. Please ensure that all information reported above matches the answers provided on the notarized report.


Allowed extensions: .pdf, .doc, .docx, .xls, .xlsx
Certification
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