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NAME OF LOBBYING ENTITY
ID NUMBER
ID NUMBER (IF AVAILABLE)
BUSINESS ADDRESS CITY STATE ZIP CODE
EXPENSES FOR WHICH LOBBYIST IS TO BE REIMBURSED (describe)
TYPE OF LOBBYIST (CHECK ONLY ONE)
Authorized Lobbyist
Lobbyist for Compensation
E-MAIL ADDRESS
PHONE NUMBER
Authorized Public Lobbyist
NAME OF EMPLOYEE WHO IS A LOBBYIST
ID NUMBER (IF AVAILABLE)
BUSINESS ADDRESS CITY STATE ZIP CODE
EXPENSES FOR WHICH LOBBYIST IS TO BE REIMBURSED
(describe)
TYPE OF LOBBYIST (CHECK ONLY ONE)
Authorized Lobbyist
Lobbyist for Compensation
E-MAIL ADDRESS
PHONE NUMBER
Authorized Public Lobbyist
NAME OF EMPLOYEE WHO IS A LOBBYIST
ID NUMBER (IF AVAILABLE)
BUSINESS ADDRESS CITY STATE ZIP CODE
EXPENSES FOR WHICH LOBBYIST IS TO BE REIMBURSED (describe)
TYPE
OF LOBBYIST (CHECK ONLY ONE)
Authorized Lobbyist
Lobbyist for Compensation
E-MAIL ADDRESS
PHONE NUMBER
Authorized Public Lobbyist
NAME OF EMPLOYEE WHO IS A LOBBYIST
ID NUMBER (IF AVAILABLE)
BUSINESS ADDRESS CITY STATE ZIP CODE
EXPENSES FOR WHICH LOBBYIST IS
TO BE REIMBURSED (describe)
TYPE OF LOBBYIST (CHECK ONLY
ONE)
Authorized Lobbyist
Lobbyist for Compensation
E-MAIL ADDRESS
PHONE NUMBER
Authorized Public Lobbyist
NAME OF EMPLOYEE WHO IS A LOBBYIST
• If the employee being added has previously been registered to lobby, their ID number MUST be listed on the form, you may search the lobbying
database HERE to see if a record of a lobbyist or employee currently exists.
