Lobbying Firm Registration Statement

Government Code Section 86104

Form 601 Instructions

Part 1 of 5: Lobbying Firm Information

Part 2 of 5: Individual Lobbyists

Part 3 of 5: Lobbyist Employers

Section A

First Lobbyist Employer

Second Lobbyist Employer

Third Lobbyist Employer

Fourth Lobbyist Employer

Fifth Lobbyist Employer

Sixth Lobbyist Employer

Section B - Subcontracted Clients

Part 4 of 5: Statement of Responsible Officer

I am a partner, owner, or officer of the lobbying firm of

I am the person responsible for filing statements and reports and keeping records required by Chapter 6 of the Political Reform Act (Government Code Sections 81000-91015). I have read and understand the prohibitions contained in Sections 86203 and 86205.

86203: It shall be unlawful for a lobbyist or a lobbying firm to make gifts to one person aggregating more than ten dollars ($10) in a calendar month, or to act as an agent or intermediary in the making of any gift, or to arrange for the making of any gift by any other person.

“Gift” as used in Section 86203 means a gift made directly or indirectly to any state candidate, elected state officer, or legislative official, or to an agency official of any agency required to be listed on the Registration Statement of the lobbying firm or the lobbyist employer of the lobbyist.

86205: No Lobbyist or lobbying firm shall:

Part 5 of 5: Verification

I have used all reasonable diligence in preparing this Statement. I have reviewed this Statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

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End of Page, Form 601