Client Information
Client Name:
Business Address:
Chief Administrative Officer:
Third Party Beneficiary:
Type of Lobbying:
Business Relationship
(To make changes or submit a Business Relationship form go to “Business Relationship” on the Client menu.)
No Business Relationship Form Submitted
Lobbyist Information
Source of Funding

Lobbying Expenses (reporting period only)
A. Aggregate expenses less or equal to $75:                                  
B. Aggregate expenses for salaried of non-lobbying employees:  
C. Itemized lobbying expenses:                                                       
D. Total Expenses (A+B+C):                                                        
Subject(s) Lobbied
Person, State Agency, Municipality, or Legislative Body Expect to Lobby
Bill, Rule, Regulation or Rate Number Expect to Lobby
Title and Identifying # of procurement contracts/documents
Number or Subject matter of Gubernatorial/Municipal Executive Order
Subject matter of and Tribes involved in Tribal State Compacts, etc.