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HomeMy Public PortalAboutHogan, Tasi - Registration - BrightlineLOBBYIST REGISTRATION FORM (One Client Per Registration Form) I.Lobbyist Information Name: ___________________________________________________________________________________________ Mailing Address: _________________________________________________________________________________ City: ________________________________ State: _________________________Zip: _________________________ Email: ______________________________ Phone: _______________________Fax: _________________________ II.Client/Principal Information Name: ___________________________________________________________________________________________ Business: ________________________________________________________________________________________ Business Address:________________________________________________________________________________ City: _______________________________State: ________________________Zip: ___________________________ Is your client: Partnership [ ] Type: __________________ Corporation [ X ] Association [ ] Trust [ ] Name: _________________ To the best of my knowledge, the above information is correct. I understand that pursuant to City Code sec. 2.191(4), I am required to file an expenditure report on February 1st and August 1st of each calendar year of any lobbying expenditures involving the City during the preceding six month period (January-June, July-December) Signature Print Name Date