PB ID
TELEPHONE NUMBER
NAME OF PUBLIC BODY
ADDRESS
CITY STATE ZIP CODE
SUMMARY OF EXPENDITURES
Total single expenditures on behalf of the Public Body whether or not made in the course of lobbying (Total from page 2):
By a Designated Public Lobbyist
By Authorized Public Lobbyists
Aggregate of expenditures of $20 or less on behalf of the Public Body whether or not made in the course of lobbying:
By a Designated Public Lobbyist
By Authorized Public Lobbyists
All expenditures by public body made in the course of lobbying to compensate or
reimburse Designated and Authorized Public Lobbyists for
expenses (Total from page 3)
Special Events (Total from page 4)
TOTAL EXPENDITURES (ADD ABOVE LINES)
PUBLIC BODIES ONLY:
BY CHECKING THE ABOVE BOX, I CERTIFY THAT THIS PUBLIC BODY HAS ESTABLISHED AND PREVIOUSLY FILED A TIME
ALLOCATION SCHEDULE FOR APPORTIONED LOBBYING ACTIVITY BASED ON ACTUAL EXPERIENCE. THERE HAS BEEN
NO CHANGE FROM PREVIOUS ANNUAL REPORTS IN THE COMPENSATION ATTRIBUTABLE TO LOBBYING FOR THE
DESIGNATED PUBLIC LOBBYIST AND ALL AUTHORIZED PUBLIC LOBBYISTS, AND THEIR JOB RESPONSIBILITIES HAVE
NOT BEEN SIGNIFICANTLY ALTERED SINCE THE TIME ALLOCATION SCHEDULE WAS ESTABLISHED.
I declare under penalty of perjury that the above information is true and correct.
Printed Name of Designated Public Lobbyist
PUBLIC BODY
REPORT YEAR
DESIGNATED PUBLIC LOBBYIST EMAIL ADDRESS
NAME OF DESIGNATED PUBLIC LOBBYIST
Conformed Signature of Designated Public Lobbyist
Page 1 of 4 A.R.S. § 41-1232.03
/S/
FILE ONLINE AT LOBBYING.AZ.GOV OR E-MAIL TO: LOBBYIST@AZSOS.GOV
2019
Page 2 of 4
ARIZONA
PUBLIC BODY ANNUAL REPORT
Single expenditures whether or not made in the course of lobbying
NAME OF LOBBYIST WHO MADE EXPENDITURE
TYPE OF LOBBYIST (SELECT ONE):
Name and Title of Person Receiving or Benefiting from Expenditure
DATE AMOUNT
Name and Title of Person Receiving or Benefiting from Expenditure
DATE AMOUNT
Name and Title of Person Receiving or Benefiting from Expenditure
DESCRIPTION OF EXPENDITURE
DATE AMOUNT
Name and Title of Person Receiving or Benefiting from Expenditure
DESCRIPTION OF EXPENDITURE
DATE AMOUNT
Name and Title of Person Receiving or Benefiting from Expenditure
DESCRIPTION OF EXPENDITURE
Name and Title of Person Receiving or Benefiting from Expenditure
DESCRIPTION OF EXPENDITURE
DATE AMOUNT
Name and Title of Person Receiving or Benefiting from Expenditure
DESCRIPTION OF EXPENDITURE
DATE AMOUNT
ENTER TOTAL SINGLE EXPENDITURES:
If additional sheets are attached, enter combined total here.
DATE AMOUNT
Designated Public Lobbyist
Authorized Public Lobbyist
Travel and Lodging
Flowers
Food or beverage
Speaking engagement
Other (please describe)
DESCRIPTION OF EXPENDITURE
Travel and Lodging
Flowers
Food or beverage
Speaking engagement
Other (please describe)
Travel and Lodging
Flowers
Food or beverage
Speaking engagement
Other (please describe)
Travel and Lodging
Flowers
Food or beverage
Speaking engagement
Other (please describe)
Travel and Lodging
Flowers
Food or beverage
Speaking engagement
Other (please describe)
Travel and Lodging
Flowers
Food or beverage
Speaking engagement
Other (please describe)
DESCRIPTION OF EXPENDITURE
Travel and Lodging
Flowers
Food or beverage
Speaking engagement
Other (please describe)
Page 3 of 4
Do not complete this page unless the expenditures were made by a Public Body.
AGG. AMT.
Personal sustenance
Filing fees
Legal fees
Employee/Lobbyist
compensation
AGG. AMT.
Food or beverages
Speaking engagement
Travel and lodging
Flowers
Personal sustenance
Filing fees
Legal fees
Lobbyist compensation
Other (Please describe)
AGG. AMT.
Food or beverages
Speaking engagement
Travel and lodging
Flowers
Personal sustenance
Filing fees
Legal fees
Lobbyist compensation
Other (Please describe)
AGG. AMT.
Food or beverages
Speaking engagement
Travel and lodging
Flowers
Personal sustenance
Filing fees
Legal fees
Lobbyist compensation
Other (Please describe)
AGG. AMT.
Food or beverages
Speaking engagement
Travel and lodging
Flowers
Personal sustenance
Filing fees
Legal fees
Lobbyist compensation
Other (Please describe)
NAME OF LOBBYIST COMPENSATED OR EIMBURSED CATEGORY OF
COMPENSATION/REIMBURSEMENT
AGG. AMT.
Food or beverages
Speaking engagement
Travel and lodging
Flowers
Personal sustenance
Filing fees
Legal fees
Lobbyist compensation
Other (Please describe)
ENTER TOTAL:
If additional sheets are attached, enter combined total here.
ARIZONA
PUBLIC BODY ANNUAL REPORT
EXPENDITURES BY PUBLIC BODY in the course of
lobbying to compensate or reimburse Designated
and Authorized Public Lobbyists
NAME OF LOBBYIST COMPENSATED OR REIMBURSED CATEGORY OF
COMP
E
NSATION/REIMBURSEMENT
NAME OF LOBBYIST COMPENSATED OR REIMBURSED CATEGORY OF
COMP
E
NSATION/REIMBURSEMENT
NAME OF LOBBYIST COMPENSATED OR REIMBURSED CATEGORY OF
COMP
E
NSATION/REIMBURSEMENT
NAME OF LOBBYIST COMPENSATED OR REIMBURSED CATEGORY OF
COMP
E
NSATION/REIMBURSEMENT
NAME OF LOBBYIST COMPENSATED OR REIMBURSED CATEGORY OF COMPENSATION/REIMBURSEMENT
Food or beverages
Speaking engagement
Travel and lodging
Flowers
Page 4 of 4
● ALL MEMBERS OF THE LEGISLATURE
● EITHER HOUSE OF THE LEGISLATURE; OR
ANY COMMITTEE OF THE LEGISLATURE
DESCRIPTION DATE LOCATION
LEGISLATIVE
BODY/COMMITTEE
TOTAL
EXPENSES
1
2
3
4
5
6
7
8
9
10
11
12
ENTER TOTAL EXPENDITURES FOR SPECIAL EVENTS:
If additional sheets are attached, enter combined total here.
ARIZONA
PUBLIC BODY ANNUAL REPORT
SPECIAL EVENTS REPORTING
EXPENDITURES FOR SPECIAL EVENTS TO WHICH ARE INVITED
EXPENDITURES MADE IN THE COURSE OF LOBBYING
ONLY REPORT EMPLOYEE COMPENSATION ATTRIBUTABLE TO LOBBYING FOR
EMPLOYEES OF THE PUBLIC BODY REGISTERED AS DESIGNATED PUBLIC LOBBYISTS OR
AUTHORIZED PUBLIC LOBBYISTS
DO NOT INCLUDE OTHER LOBBYIST COMPENSATION OR EMPLOYEE REIMBURSEMENT
PB ID
TELEPHONE NUMBER
NAME OF PUBLIC BODY
ADDRESS
CITY STATE ZIP CODE
PUBLIC BODY EMPLOYEE WHO IS A REGISTERED LOBBYIST NAME
EMPLOYEE COMPENSATION
ATTRIBUTABLE TO LOBBYING
TOTAL:
If additional s
heets are
attached,
e
nter
combined
total here.
THIS PAGE MUST BE COMPLETED AND FILED IF THE PUBLIC BODY HAS NOT PREVIOUSLY FILED AND
ATTACHED A COPY OF THEIR TIME ALLOCATION SCHEDULE FOR APPORTIONED LOBBYING ACTIVITY.
Printed Name of Designated Public Lobbyist
Conformed Signature of Designated Public Lobbyist
/S/
PUBLIC BODY
FOR ELECTRONIC FILING ONLY. MAIL TO LOBBYIST@AZSOS.GOV
I declare under penalty of perjury that the above information is true and correct.
Page 1 of 1 A.R.S. § 41-1232.03