Quarterly Financial Report

Is this a change request?

Yes

Lobbyist Information

Reporting Period

Year

Lobbyist First Name

Lobbyist Last Name

Lobbyist Email

Lobbyist Firm or Organization Information

Name of Lobbyist's Employer

Phone Number

Gross Income Received from Client

Client Name

Total gross income for lobbying received the lobbyist received during the previous quarter

(1) Expenditure for lobbying a covered official

(1) Name of the client or employer on whose behalf money is expended

(1) Name and title of the covered official lobbied

(1) Date lobbied

(1) Official action on which the covered official was lobbied

(1) An itemized list and estimated value of any gift, entertainment, or direct expenditure equal to or in excess of $75.00 to, on behalf of, or benefitting the covered official for lobbying purposes, including, but not limited to: monies, tickets, gratuities, expressed agreements, or any tangible thing of value of any amount.

Add another expenditure?

Yes

(2) Expenditure for lobbying a covered official

(2) Name of the client or employer on whose behalf money is expended

(2) Name and title of the covered official lobbied

(2) Date lobbied

(2) Official action on which the covered official was lobbied

(2) An itemized list and estimated value of any gift, entertainment, or direct expenditure equal to or in excess of $75.00 to, on behalf of, or benefitting the covered official for lobbying purposes, including, but not limited to: monies, tickets, gratuities, expressed agreements, or any tangible thing of value of any amount.

Add another expenditure?

Yes

(3) Expenditure for lobbying a covered official

(3) Name of the client or employer on whose behalf money is expended

(3) Name and title of the covered official lobbied

(3) Date lobbied

(3) Official action on which the covered official was lobbied

(3) An itemized list and estimated value of any gift, entertainment, or direct expenditure equal to or in excess of $75.00 to, on behalf of, or benefitting the covered official for lobbying purposes, including, but not limited to: monies, tickets, gratuities, expressed agreements, or any tangible thing of value of any amount.

Add another expenditure?

Yes

(4) Expenditure for lobbying a covered official

(4) Name of the client or employer on whose behalf money is expended

(4) Name and title of the covered official lobbied

(4) Date lobbied

(4) Official action on which the covered official was lobbied

(4) An itemized list and estimated value of any gift, entertainment, or direct expenditure equal to or in excess of $75.00 to, on behalf of, or benefitting the covered official for lobbying purposes, including, but not limited to: monies, tickets, gratuities, expressed agreements, or any tangible thing of value of any amount.

Add another expenditure?

Yes

(5) Expenditure for lobbying a covered official

(5) Name of the client or employer on whose behalf money is expended

(5) Name and title of the covered official lobbied

(5) Date lobbied

(5) Official action on which the covered official was lobbied

(5) An itemized list and estimated value of any gift, entertainment, or direct expenditure equal to or in excess of $75.00 to, on behalf of, or benefitting the covered official for lobbying purposes, including, but not limited to: monies, tickets, gratuities, expressed agreements, or any tangible thing of value of any amount.

Add another expenditure?

Yes

(6) Expenditure for lobbying a covered official

(6) Name of the client or employer on whose behalf money is expended

(6) Name and title of the covered official lobbied

(6) Date lobbied

(6) Official action on which the covered official was lobbied

(6) An itemized list and estimated value of any gift, entertainment, or direct expenditure equal to or in excess of $75.00 to, on behalf of, or benefitting the covered official for lobbying purposes, including, but not limited to: monies, tickets, gratuities, expressed agreements, or any tangible thing of value of any amount.