Fillable Form 2: 4 1 3 LOBBYIST PLEASE SUBMIT (Arizona Secretary of State)

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Form 2: 4 1 3 LOBBYIST PLEASE SUBMIT (Arizona Secretary of State)

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BROWSE ARIZONA SECRETARY OF STATE (AZ) FORMS

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SUMMARY OF EXPENDITURES
Total single expenditures incurred by lobbyist whether or not
made in the course of lobbying:
• Made on behalf of a principal
or public body (p. 2):
• Not made on behalf of a
principal or public body (p. 3):
Aggregate of expenditures of $20 or less incurred by lobbyist
whether or not made in the course of lobbying:
• Made on behalf of a principal
or public body (p.4):
• Not made on behalf of a
principal or public body:
Total special event expenditures incurred by lobbyist whether
or not made in the course of lobbying:
• Made on behalf of a principal
or public body (p. 6):
• Not made on behalf of a
principal or public body (p. 7):
TOTAL EXPENDITURES (ADD ABOVE LINES):
By
signing, I declare under penalty of perjury that the information provided on this form is true, complete, and correct.
Name of Designated Lobbyist/Lobbyist for Compensation
Conformed Signature of Designated Lobbyist/Lobbyist for Compensation
Page 1 of 6
LOBBYIST ID
LOBBYIST NAME
E-MAIL ADDRESS BUSINESS TELEPHONE
BUSINESS ADDRESS
CITY STATE ZIP CODE
YEAR
QUARTER
LOBBYIST
PLEASE SUBMIT VIA EMAIL TO LOBBYIST@AZSOS.GOV
1
2
3
4
/S
/
2019
CURRENT QUARTER
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
ARIZONA
LOBBYIST QUARTERLY EXPENDITURE REPORT
SINGLE EXPENDITURES
MADE ON BEHALF OF A PRINCIPAL OR PUBLIC BODY
A.R.S. §§ 41-1232.02(B), 41-1232.03(B)
Page 2 of 6
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF EXPENDITURE WAS MADE PPB ID
Name of Lobbyist or person making
expenditure
Name and Title of Person
∗∗
Receiving or
Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Food or beverage
Speaking engagement
Travel and Lodging
Flowers
DATE AMOUNT
Other (please describe)
Name of Lobbyist or person making
expenditure
Name and Title of Person
∗∗
Receiving or
Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Food or beverage
Speaking engagement
Travel and Lodging
Flowers
DATE AMOUNT
Other (please describe)
Name of Lobbyist or person making
expenditure
Name and Title of Person
∗∗
Receiving or
Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Food or beverage
Speaking engagement
Travel and Lodging
Flowers
DATE AMOUNT
Other (please describe)
Name of Lobbyist or person making
expenditure
Name and Title of Person
∗∗
Receiving or
Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Food or beverage
Speaking engagement
Travel and Lodging
Flowers
DATE AMOUNT
Other (please describe)
Name of Lobbyist or person making
expenditure
Name and Title of Person
∗∗
Receiving or
Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Food or beverage
Speaking engagement
Travel and Lodging
Flowers
DATE AMOUNT
Other (please describe)
Name of Lobbyist or person making
expenditure
Name and Title of Person
∗∗
Receiving or
Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Food or beverage
Speaking engagement
Travel and Lodging
Flowers
DATE AMOUNT
Other (please describe)
Name of Lobbyist or person making
expenditure
Name and Title of Person
∗∗
Receiving or
Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Food or beverage
Speaking engagement
Travel and Lodging
Flowers
DATE AMOUNT
Other (please describe)
ENTER TOTAL SINGLE EXPENDITURES:
If additional sheets are attached, enter combined total here.
∗∗
Filers representing Principals must report expenditures received by or benefiting state officers or employees; filers representing Public
Bodies must report expenditures received by or benefiting any member of the legislature.
ARIZONA
LOBBYIST QUARTERLY EXPENDITURE REPORT
SINGLE EXPENDITURES
NOT MADE ON BEHALF OF A PRINCIPAL OR PUBLIC BODY
A.R.S. §§ 41-1232.02 (B), 41-1232.03 (B)
Page 3 of 6
Name and Title of Person
∗∗
Receiving or Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Travel and
Lodging Flowers
DATE AMOUNT
Food or beverage
Speaking engagement
Other (please describe)
Name and Title of Person Receiving or Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Travel and
Lodging Flowers
DATE AMOUNT
Food or beverage
Speaking engagement
Other (please describe)
Name and Title of Person Receiving or Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Travel and
Lodging Flowers
DATE
AMOUNT
Food or beverage
Speaking engagement
Other (please describe)
Name and Title of Person Receiving or Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Travel and
Lodging Flowers
DATE
AMOUNT
Food or beverage
Speaking
engagement
Other
(pleas
e describe)
Name and Title of Person Receiving or Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Travel and
Lodging Flowers
DATE
AMOUNT
Food or beverage
Speaking engagement
Other (please describe)
Name and Title of Person Receiving or Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Travel and
Lodging Flowers
DATE
AMOUNT
Food or beverage
Speaking engagement
Other (please describe)
Name and Title of Person Receiving or Benefiting from Expenditure
CATEGORY OF EXPENDITURE
Food or beverage
Travel and
Lodging Flowers
DATE
AMOUNT
Name and Title of Person Receiving or Benefiting from Expenditure
Speaking engagement
Other (please describe)
CATEGORY OF EXPENDITURE
Food or beverage
Speaking engagement
Travel and
Lodging Flowers
DATE
AMOUNT
Other (please describe)
ENTER TOTAL SINGLE EXPENDITURES:
If additional sheets are attached, enter combined total here.
ARIZONA
LOBBYIST QUARTERLY EXPENDITURE REPORT
AGGREGATE EXPENDITURES
MADE ON BEHALF OF A PRINCIPAL OR PUBLIC BODY
A.R.S. §§ 41-1232.02 (B), 41-1232.03 (B)
Page 4 of 6
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID
AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF LOBBYIST MADE EXPENDITURE PPB ID AGG AMOUNT
ENTER TOTAL EXPENDITURES:
If additional s
heets are
attached,
e
nter
combined
total here
.
ARIZONA
LOBBYIST QUARTERLY EXPENDITURE REPORT
SPECIAL EVENTS EXPENDITURES
MADE ON BEHALF OF A PRINCIPAL OR PUBLIC BODY
A.R.S. §§ 41-1232.02(F) AND 41-1232.03(F)
Page 5 of 6
PRINCIPAL/PUBLIC BODY ON WHOSE BEHALF EXPENDITURE WAS MADE PPB ID
EXPENDITURES FOR SPECIAL EVENTS TO WHICH ARE INVITED
• ALL MEMBERS OF THE LEGISLATURE
• EITHER HOUSE OF THE LEGISLATURE; OR
• ANY COMMITTEE OF THE LEGISLATURE
DESCRIPTION DATE LOCATION
LEGISLATIVE
BODY/COMMITTEE
TOTAL EXPENSES
ENTER TOTAL EXPENDITURES FOR SPECIAL EVENTS:
If additional sheets are attached, enter combined total here.
ARIZONA
LOBBYIST QUARTERLY REPORT
SPECIAL EVENTS EXPENDITURES
NOT MADE ON BEHALF OF A PRINCIPAL OR PUBLIC BODY
A.R.S. §§ 41-1232.02(F) AND 41-1232.03(F)
Page 6 of 6
EXPENDITURES FOR SPECIAL EVENTS TO WHICH ARE INVITED
• ALL MEMBERS OF THE LEGISLATURE
• EITHER HOUSE OF THE LEGISLATURE; OR
• ANY COMMITTEE OF THE LEGISLATURE
DESCRIPTION
DATE LOCATION LEGISLATIVE BODY TOTAL EXPENSES
ENTER TOTAL EXPENDITURES FOR SPECIAL EVENTS:
If additional
sheets are attached, enter combined total here.
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Form 2: 4 1 3 LOBBYIST PLEASE SUBMIT (Arizona Secretary of State)

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Completed 20 July 2020

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