Please return via email to ethicscommission@oaklandca.gov
Filings sent by mail or fax are also accepted. Send to: Public Ethics Commission
1 Frank H. Ogawa Plaza, 1st Floor, Room 104 Oakland, CA 94612 Fax: (510) 238-3315
Date Received
RESERVED FOR PUBLIC ETHICS USE
CITY OF OAKLAND PUBLIC ETHICS COMMISSION
2019 LOBBYIST REGISTRATION FORM
Full Name:
Name of Lobbying Firm or Employer:
Lobbying Firm/Employer Business Address:
City, State, Zip Code
Work Phone:
Work Email:
Please check one:
Client Contracted Lobbyist
Employer In-House Lobbyist
Please check one:
Initial Lobbyist
Registration
Lobbyist Registration
Amendment to Lobbyist
Registration
Names of all clients/employers
(Print out full name, do not use
acronyms)
Specific governmental actions
seeking to influence
(Use a separate row for each
governmental action seeking to
influence, even of for same
client/employer)
Position advocating
(Support, Oppose, Policy
Development,
Informational Briefing,
Other)
Choose one from the
drop-down menu
Note that no person shall engage in any activity on behalf of a client as a local governmental lobbyist unless
he or she has registered using this form and listed such client with the Public Ethics. Lobbyists are further
required to file Lobbyist Quarterly Reports no later than 30 days after the end of each calendar quarter.
I declare under penalty of perjury under the laws of the State of California that the information I provided to
complete this form is true and correct.
Date: ___________________ Signature: _____________________________________