FORM 1A

:
INITIAL REGISTRATION REPORT
FOR CONTRACT LOBBYISTS
Name of Filer: ___________________________________________________________________
Business Address: ________________________________________________________________
Business Phone Number: ___________________________________________________________

I.

INFORMATION ABOUT THE FILER

If the filer is an entity, name each individual who is an owner, partner or officer of the filer. If the
filer is a sole proprietorship, name the sole proprietor. If the filer is a corporation, however
organized, name each officer. If the filer is a partnership, however organized, and if the partnership
has 10 (ten) or more partners, name the partnership. If the filer is a partnership, however organized,
and if the partnership has fewer than 10 (ten) partners, name each partner.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

If the filer is an individual, name the filer’s employer and describe the employer’s business activity.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Form 1A: Initial Registration Report for Contract Lobbyists
05/31/00

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Name each person employed or retained by the filer, at the time of this filing or at any time during
the two months immediately preceding this filing, to contact City officers.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Report the total number of contacts with City officers made during the two months preceding this
filing. ___________________________

Report the total payments promised* by clients in exchange for lobbyist services during the three
months preceding this filing.
$________________________________

Report the total economic consideration received from clients in exchange for lobbyist services during
the three months preceding this filing.
$________________________________

* A payment is “promised” regardless of whether the lobbyist services for which the promise is made
are to be performed within the reporting period.

Form 1A: Initial Registration Report for Contract Lobbyists
05/31/00

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II.

INFORMATION ABOUT THE FILER’S CLIENTS

For each client on whose behalf the filer provided lobbyist services during the two months
preceding this filing, report the following :
Name of Client:______________________________Telephone:____________________________
Business Address:_________________________________________________________________
Describe in detail the legislative or administrative action the filer was retained to influence and the
outcome sought by the filer.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Identify each City officer and City department contacted by the filer on behalf of the client.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Name of Client:______________________________Telephone:____________________________
Business Address:_________________________________________________________________
Describe in detail the legislative or administrative action the filer was retained to influence and the
outcome sought by the filer.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Identify each City officer and City department contacted by the filer on behalf of the client.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
o If additional space is required, check here and attach additional sheets.
Form 1A: Initial Registration Report for Contract Lobbyists
05/31/00

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III. REPORT OF POLITICAL CONTRIBUTIONS
Report the total amount of political contributions made or delivered by the filer, or made by a client
at the behest of the filer, or for which the filer served as an agent or intermediary, during the two
months preceding this filing. $____________
For each political contribution of $100 or more, report the following :
Name the City officer, candidate for City office or committee to which the contribution was made:
________________________________________________________________________________
Amount of the contribution: $____________
Check all that apply:

o
o
o
o
o

Filer made the contribution
Filer delivered the contribution
A client made the contribution at the behest of the filer
Filer arranged for the contribution
Filer served as an agent or intermediary in making the
contribution

If the filer delivered a contribution from another source, arranged or served as an agent or
intermediary in making a contribution for another, or if a client made a contribution at filer’s behest,
identify the true source of the funds:
________________________________________________________________________________

Name the City officer, candidate for City office or committee to which the contribution was made:
________________________________________________________________________
________
Amount of the contribution: $____________
Check all that apply:

o
o
o
o
o

Filer made the contribution
Filer delivered the contribution
A client made the contribution at the behest of the filer
Filer arranged for the contribution
Filer served as an agent or intermediary in making the
contribution

If the filer delivered a contribution from another source, arranged or served as an agent or
intermediary in making a contribution for another, or if a client made a contribution at filer’s behest,
identify the true source of the funds:
________________________________________________________________________________

Form 1A: Initial Registration Report for Contract Lobbyists
05/31/00

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o If additional space is required, check here and attach additional sheet

Form 1A: Initial Registration Report for Contract Lobbyists
05/31/00

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