Fillable PRINCIPAL - PUBLIC BODY (Arizona Secretary of State)

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PRINCIPAL - PUBLIC BODY (Arizona Secretary of State)

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NAME OF PRINCIPAL OR PUBLIC BODY
P/PB ID NUMBER
PREVIOUS DESIGNATED LOBBYIST/DESIGNATED PUBLIC LOBBYIST
PREVIOUS DESIGNATED LOBBYIST ID#
LOBBYIST ID NUMBER
NEW DESIGNATED LOBBYIST NAME
E-MAIL ADDRESS BUSINESS TELEPHONE
BUSINESS ADDRESS
CITY STATE ZIP CODE
EXPENSES FOR WHICH LOBBYIST IS TO BE REIMBURSED (Describe)
By signing, I declare under penalty of perjury that the information provided on this form is true, complete, and correct.
Name of Designated Lobbyist
Conformed Signature of Designated Lobbyist
/S
/
PRINCIPAL - PUBLIC BODY
FILE ONLINE AT LOBBYING.AZ.GOV OR E-MAIL TO: LOBBYIST@AZSOS.GOV
Page 1 of 1 A.R.S. §§ 41-1232 (C), 41-1232.01 (C)
IS LOBBYIST COMPENSATED FOR LOBBYING ACTIVITY?
YES
NO
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PRINCIPAL - PUBLIC BODY (Arizona Secretary of State)

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Completed 20 July 2020

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