Fillable Lobbying Registration Form (City of Annapolis)

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Lobbying Registration Form (City of Annapolis)

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U.S.A. forms for City of Annapolis

BROWSE CITY OF ANNAPOLIS (MD) FORMS

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Lobbying Registration Form
Due by January 31st of each year, or within fifteen days after the
commencement of any activities regulated by City of Annapolis Code
Section 2.08.070.
Registrant information
Name
Business address
Phones Office Home
Representation information
Names and addresses of all individuals, business entities, or other organizations on whose behalf Registrant acts on or will
be acting:
Subject matters and/or activities regarding which Registrant acts or will be acting:
Duration of this registration statement (not to exceed one calendar year):
From To
Signature Date
City of Annapolis
Ethics Commission
c/o Office of Law
160 Duke of Gloucester Street
Annapolis, MD 21401-2517
Ethics@annapolis.gov • 410-263-7954 • Fax 410-268-3916 • TDD use MD Relay or 711 • www.annapolis.gov
Revised Dec. 19, 2019
1
Lobbying Activity Report
Registrants shall file a report, not later than January 31
st
of each year, covering activities for which they were registered for
the preceding year, disclosing the value, date and nature of any food, entertainment or gifts provided to any city official or
employee.
Nature of any food, entertainment or gift Value * Date
* When a gift or series of gifts to a single official or employee exceeds thirty-five dollars in value, the official or employee
shall be identified.
I DO HEREBY DECLARE AND AFFIRM under the penalty of perjury that the information set forth above is true and correct
to the best of my knowledge and belief.
Signature Date
City of Annapolis
Ethics Commission
c/o Office of Law
160 Duke of Gloucester Street
Annapolis, MD 21401-2517
Ethics@annapolis.gov • 410-263-7954 • Fax 410-268-3916 • TDD use MD Relay or 711 • www.annapolis.gov
Revised Dec. 19, 2019
2
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Lobbying Registration Form (City of Annapolis)

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Completed 12 January 2021

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