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lobbyblank
LOBBY REGISTRATION FORM, ACTIVITIES REPORT, AND TERMINATION NOTICE
November 1998 Office ofthe City Secretary, P.O. Box 1562, Houston, Texas 77251 Phone: (713) 247-1840 Public Level, City Hall Annex 900 Bagby Houston, Texas 77002
CITY OF HOUSTON LOBBYING REGISTRATION AND ACTIVITIES REPORTING INSTRUCTION GUTDE TABLE OF CONTENTS GENERAL INSTRUCTIONS:
DEFINITIONS FILLING OUT THE FORMS PHOTOCOPIES OF FORMS REQUIRED FILING OF DUPLICATE REPORTS FILING DEADLINES CHANGES TO LOBBY REGISTRATION REPORTING EXPENDITURES QUESTIONS ABOUT COMPLIANCE
FILLING OUT THE CITY OF HOUSTON LOBBY REGISTRATION FoRM FILLING OUT THE CITY OF HOUSTON LOBBY ACTIVITIES REPORT Fol~M APPENDIX
CITY OF HOUSTON LOBBY REGISTRATIONFORM COVER SHEET REGISTRATION SCHEDULE A: ENTITY, EMPLOYER, OR OTHER PERSONREPRESENTED; SUBJECT MAITER CITY OF HOUSTON LOBBY ACTIVITIES REPORT COVER SHEET ACTIVITIES SCHEDULE A: SUBJECTMATFER ACTIVITIES SCHEDULE B: OPERATIONAL EXPENSES FOR DIRECT COMMUNICATION OTHER THAN BENEFITS TO MEMBERS ACTIVITIES SCHEDULE
C: EXPENDITURES, GIFTS AND HONORARIA
ACTIVITIES SCHEDULE D: EXCHANGES WiTH MEMBER’S BUSINESS ENTITIES LOBBY TERMINATIONNOTICE CORRECTED CITY OF HOUSTON LOBBY ACTIVITIES REPORT AND GOOD-FAITH AFFIDAVIT
Note: In addition to the provisions ofthe City ofHouston Lobbying Ordinance, effective November 24, 1998 (Art. V, Cli. 18, Code of Ordinances), Texas law prohibits certain types of expenditures benefiting munic4al officers and employees andplaces caps on certain other types ofexpenditures benefiting municipal officers and employees.
City of Houston LOBBY REGISTRATION AND REPORTING Form
Copies ofArticle V, Chapter 18 ofthe Code of Ordinances, Houston, Texas, (lobby ordinance) are available from the Office ofthe City Secretary upon payment ofthe required charge of 100 per page.
The following instructions are substantially similar to those used by the State of Texas.
References in parentheses are to sections of the
registration, a direct communication includes a
City ofHouston Code of Ordinances. DEFINITIONS. Refer to Sec. 18-71 for applicable definitions.
gift ortransfer ofanything of value to a member as an expression ofgood will or the extension of hospitality to a member even if no business is discussed. If you are registered as a lobbyist with the Office ofthe City Secretary, you are required to file quarterly reports on your lobby expenditures as well as any amended registration information. The quarterly reports are due no later than the tenth day ofthe month following each calendar quarter covering lobby activities that occurred during the preceding quarter unless no reportable activity occurred during that quarter. A document is considered “filed” with the City Secretary once received on either: (1) (2) the workday it is hand-delivered, as long as it is received by 5 p.m.; or the date it is mailed, as evidenced by the. post office cancellation mark or a receipt mark from a common or contract carrier. (A postage meter cancellation date is not, by itself, evidence of the date of mailing.) (Sec. 18-79).
All forms must be either typewritten or handwritten in ink.
You may use photocopies of blank City of Houston forms. Any form filed with the City Secretary, however, must have an original signature. Note: You should retain copies of all reports filed with the City Secretary.
REQUIRED FILING OF DUPLICATE RECORDS.
Each person required to file a registration or report shall file: • • The original registration or report; and One photocopy or other exact duplicate ofthe original registration or report.
Note: When a filing deadline falls on a City holiday or a weekend, the deadline is extended to the next City business day. The Office of the City Secretary is located at 900 Bagby, Public Level, City Hall Annex, Houston, Texas 77002. The mailing address for the City Secretary is P.O. Box 1562, Houston, TX 77251.
A registration form must be filed by a person meeting either the compensation or expenditure threshold of $200 in a calendar quarter not later than 5 working days after the first direct communication with a member ofthe legislative or executive branch that requires the person’s registration. (Sec. 18-74(a)). For purposes of
CHANGES TO LOBBY REGISTRATION.
To change information provided in your initial LOBBY REGISTRATION, you must file a quarterly LOBBY ACTIVITIES REPORT showing the changed information.
reported by another person who is required or permitted to report that lobby expenditure. You may reasonably apportion the expenditure you made for a group if you cannot determine the actual amount you spent for each person.
For reporting purposes, a “lobby expenditure” is an expenditure made to communicate to influence legislation or administrative action.
LOBBY EXPENDITURE.
A lobby expenditure for your own transportation, food and beverages, lodging, or entertainment is not reportable.
A lobby expenditure is madewhen the amount of the expenditure is readily determinable
by the registrant or a person acting on
his behalf who makes the expenditure. If the normal business of a vendor or service provider is to make the amount charged known by sending a bill after
expenses are incurred, the date of the
You do not have to include in the amount you report any sales tax or tip associated with a lobby expenditure.
expenditure, for reporting purposes, is the date you receive the bill. If you pay for a restaurant meal with a credit card, however, your bill is the restaurant receipt, not the statement from the credit card company that arrives the following month. You must report any lobby expenditure you make on the Lobbying Activity Report form, even if you were reimbursed for that expenditure (for example, by your employer or client).
REIMBURSED EXPENDITURES. EXPENDITURES MADE BY OTHERS ON YOUR BEHALF. A lobby expenditure
Questions from persons subject to the ordinance about compliance should be forwarded to the City of Houston Legal Department, Lobbying Advisory Committee, P.O. Box 1562, Houston, Texas 77251. Requests for an opinion about the application of the ordinance to the requestor in regard to a specified existing or hypothetical factual situation must be in writing, be signed, contain a return address, and provide sufficient detail to explain the question. All written requests and written opinions will be kept on file in the Office of the City Secretary and available
for public inspection at all times. The pendency
of a request will not serve to extend any applicable deadlines under the ordinance.
made by someone else with your consent or ratification must be included on your Activities Report form.
NO DOUBLE REPORTING REQUIRED.
You are not required to report a lobby expenditure that you know is being Page 2 of 2
City of Houston LOBBY REGISTRATION Form
FILLING OUT THE CITY OF HOUSTON LOBBY REGISTRATION FORM
REGISTRATION COVER SHEET 1.
NUMBER OF REGISTRATION SCHEDULE A’s FILED.
Provide mailing address if different from permanent street address. 9. (Optional) Provide business phone number or, if none, home telephone number.
REGISTRANT PHONE NUMBER.
Indicate the number of Schedule A’s filed with the Registration Cover Sheet. You must complete a separate Schedule A for each employer, client or person represented orifnone, for each subject matter advanced on behalf of your own personal interests. Enter the total number of Schedule A’s you are filing and grand total pages filed. 2. 18-74(b)). Indicate whether filing is original or amended registration. If original registration, $20 fee should be attached.
NATURE OF FILING. (Sec.
10. REGISTRANT STATUS. (Sec. 18-74(a)(4)). Indicate if registrant is a lobby firm employee and, if so, provide the name, address and phone number (optional) of the firm. 11. SIGNATURE. (Sec. 18-74(a)). The City of Houston Registration Form must be signed and verified. If the registrant is an entity, the person who signs the registration form must be a person whose actions legally bind the organization, such as the owner, an officer or a director.
(Sec. 18-74(a)(1)). Provide your name or name of registrant if different.
18-72) Indicate whether registration is required because of registrant expenditures or compensation or reimbursement, or both.
REASON FOR REGISTRATION. (Sec.
REGISTRATION SCHEDULE A: ENTITY, EMPLOYER, OR OTHER PERSON REPRESENTED; SUBJECT MATTER Use a separate Registration Schedule A to report information concerning each entity, employer, or other person represented or, if none, each subject matter advanced on behalf of your own personal interest. (Sec. 18-74(a)). Part 1—General Information 1.
TOTAL PAGES OF SCHEDULE A’s FILED. Attach additional copies of Registration
(Sec. 18-74(a)). Indicate whether registrant is an individual.
NATURE OF REGISTRANT. REGISTRANT’S BUsINESS.
74(a)(2)). Describe nature of registrant’s normal business and provide name of business, if any. 7.
ADDRESS. (Sec. 74(a)(1)). Give permanent street address. REGISTRANT
Schedule A as needed. Enter the total number pages. ~Each side you complete counts as a page.) Number all pages. 2.
REGISTRANT MAILING ADDRESS. (Sec.
1 8-74(a)(1)). Page 1 of2
Provide registrant name as it appears on the Registration Cover Sheet.
PERSONALREPRESENTATION.
Part 3—Expenditures
Indicate whether you are representing only your own personal interest.
ENTITY, EMPLOYER, OR OTHER PERSON
11. EXPENDITURES.
Indicate whether you have made or reasonably expect to make expenditures (both operational and to benefit a member)
REPRESENTED. (Sec. 1 8-74(a)(2). Enter name, if any, or “none” as applicable.
ADDRESS OF PERSON REPRESENTED. (Sec. 1 8-74(a)(2)). Enter address of entity, employer, or other person represented.
NATURE OF BusINEss OR ORGANIZATION REPRESENTED. (Sec. 1 8-74(a)(2)).
of $200 or more in the calendar quarter, not including your own travel, food, lodging or membership dues. In computing the amount, include amounts under $25 spent to benefit a member even though they are not reportable on your Lobby Activity Report. (Secs. 1 8-72(a)(1); 1 8-75(a)(2) and (3)). Part 4—Subject Matter 12. SUBJECT MATTER. (Sec. 18-74(a)(3)). Check the appropriate box(es) for the subject matter of the lobbying effort. Note that the list includes good will/hospitality, which may be applicable if no subject matter was discussed as part of a direct communication. Please describe the subject matter under “other” if it is not listed. 13. DESIGNATION. (Secs. 18-71, administrative action, municipal legislation; 18-74(3)). Provide any applicable contract, agenda, docket, ordinance, motion or case numbers and the department, board, committee or other group that is related to the subject of the lobbying effort. If no designation is applicable, indicate by checking the box. Check the appropriate box if additional pages are attached with respect to No. 13.
Describe nature of the business or organization represented. Part 2—Compensation orReimbursement 7.
COMPENSATION OR REIMBURSEMENT. If you are registering because you received or reasonably expect to receive $200 or more in compensation or reimbursement in the calendar quarter, not including your own travel, food, lodging or membership dues, complete Part 2 (Nos. 8-10). If not,
check the box in No. 7 and skip to Part 3. (Sec. 1 8-72(a)(2)).
8. NATURE OF COMPENSATION OR REIMBURSEMENT. (Sec. 1 8-74(a)(5)). Indicate whether your compensation or
reimbursement is not contingent, totally contingent or partially contingent on the
outcome of the lobbying effort. 9. STATUS OF COMPENSATION OR REIMBURSEMENT. Indicate whether the compensation or
reimbursement has been paid, has been
earned but not received, or is prospective. 10. REGISTRATION FOR ENTITY. (Secs. 18-
74(a)(4)). Indicate whether you are registering for an entity. If so, enter the name, address and phone number (optional) ofthe entity. Page 2 of 2
City of Houston LOBBY ACTIVITIES REPORT
FILLING OUT THE CITY OF HOUSTON LOBBY ACTIVITIES REPORT
Final. LOBBY REGISTRATION automatically terminates one year from the date of filing if not sooner terminated by the filing ofLOBBY TERMINATION NOTICE and a LOBBY ACTIVITIES REPORT designated as a “FiNAL” report. (Sec. 18-77(b)).
Number ofPages of Activity Schedules Filed. Indicate which Activity Schedules you are filing. Enterthe total number of Activity Schedules you are filing and grand total pages filed. Changes in Registration Information. Ifinformation on original registration has changed, also submit amended Registration Cover Sheet and Registration Schedule A. (Sec. 18-75(a)(1)).
Report Deadline. Quarterly reports are due the tenth day of the month following the end of a calendar quarter (January, April, July, and October). (Sec. 18-75(a)). Period Covered. Quarterly reports generally cover the preceding quarter. For example, a quarterly report due on April 10 covers the period from January through March 31. The first quarterly report following the effective date of the ordinance (November 24, 1998) is due by January 10, 1999, and covers the period November 24 December 31, 1998. (Sec. 18-75(a)).
2. Account Number. Provide the account number assigned to you by the City
Contact the Office of the City Secretary (713) 247-1840 ifyou do not know your account number. 3. Registrant Name. Provide registrant’s name as listed on the LOBBY REGISTRATION COVER SHEET at the top of each page and Schedule ofthis form that you complete. Report Type:
Mark this box ifyou are filing a quarterly activity report. (Sec. 18-75(a)).
A final report covers the period that begins on the first day after your most recent LOBBY ACTIVITIES REPORT filed for this calendar year. The period ends on the date you file a “Final” report and a LOBBY TERMINATION NOTICE with the City Secretary. (Sec. 18-77(b)).
EXPENDITURE TOTALS: 7. Operational. You must report operational expenditures by type of expenditure in Item 7. Do not include under operational expenses any expenditures for your own transportation, lodging, food, beverages, or entertainment or for your own attendance at political fund-raisers or charity events. (Sec. 1 8-75(a)(2)). You must attribute the expenditures to the persons benefited. A lobby expenditure is attributed as follows: • expenditures for food or beverages, to the person who consumed the food or beverage; expenditures for transportation or lodging, to the person for whom the transportation or lodging expenses were paid; expenditures for entertainment
to the person for whom the admission or ticket price was paid; or
Expenditures, Gifts and Honoraria to Benefit Member ($250 or more). If a lobby expenditure was for a gift, award or memento presented to an officer or employee ofthe executiveor legislative branch of City government in connection with a nonreportable expenditure for the officer’s or employee’s attendance at a political fund-raising or charitable event, report the gift, award, or memento as a gift here and on Activities Schedule C. Aggregate Expenditures, Gifts and Honoraria (less that $250 but more than $25). You must also report the aggregate lobby expenditures, gifts and honoraria to benefit a member of less than $250 but more than $25 under Question 9 and on Activities Schedule C.
10. Individual Reporting for Entity. Indicate whether or not you are filing the report on behalfof an entity. If yes, give name, address and telephone number (optional) of the entity. (Sec. 18-75(a)). 11. Signature. The City of Houston LOBBY ACTIVITIES REPORT must be signed and verified. If the registrant is an entity, the person who signs the activity report must be a person whose actions legally bind the organization, such as the owner, an officer, or a director. (Sec. 18-75(a)).
expenditures for a gift, including an award, or memento, to the personreceiving the gift, award,
Family of Legislative/Executive Branch Member and Others in Whose Welfare Member Is Interested. Report total lobby expenditures attributable to a spouse or child of a member of the executive or legislative branch of City government or any other personin whose welfare the member is interested. (Secs. 18-71 and 18-2; “benefit”) Page 2 of 6
Use Activities Schedule A to report the subject matter ofyour communications with officers and employees of the executive or legislative branch of GUY government during the reportingperiod You must report the subject matter of such communications by you, by anyone you retain or employ to communicate on your behalf; or by anyone appearing on your behalf You are not required to include subjectmattersyou have already reported on your original or amended LOBBY REGISTRATION (Sec. 18-75(a)(1)). 1. Total Pages of Activities Schedule A Filed.
Attach additional copies of ACTIVITIES SCHEDULE A as needed. After you have completed SCHEDULE A, count the total number of pages of SCHEDULE A and write the total in this box. (Each side you complete counts as a page.) Number all pages. 2. Registrant Name. Provide registrant’s name as it appears on the Registration Cover Sheet. (Sec. 18-
employee of City government during the reporting period. You are not required to check categories included on your lobby registration or on an amended registration. (Sec. I 8-75(a)(1)). 5. Agenda, Contract, Ordinance, Motion, Case, or Docket Numbers. List the docket, agenda item, ordinance, motion, case, or contract or similar
number and the name of the City
department, office or agency at which any administrative or legislative matter is pending about which you, anyone you retain or employ to appear on your behalf, or anyone who appears on your behalf communicated with an officer or employee of the executive or legislative branch of City government during the reportingperiod. Attach additional pages as necessary. (Secs. 1871—administrative action; municipal legislation; 1 8-75(a)(1)).
Activities Schedule B: Operational Expenses for Direct Communication Other Than Benefits to Members
75(a)(1)). 3. Account Number. Provide your account number. Subject Matter Categories. Check all boxes that describe the general subjects about which you, anyone you retain or employ to appear on your behalf, or anyone who appears on your behalf communicated with an officer or 1. Registrant Name. Provide registrant’s name as it appears on Registration Cover Sheet. (Sec. 1875(a)(1). Total Pages of Activities Schedule B Filed. Attach additional copies of the Schedule B page as needed. After you have
completed Schedule B, count the total number ofpages of Schedule B and write that number in the blank provided. Number each ofthe pages. 3. Operational 75(a)(2a)). Expense (Sec. 18-
Schedule C: Expenditures, Gifts and Honoraria to Benefit a Member
1. Registrant Name. Provide registrant’s name as it appears on your registration cover sheet.
A. Total Compensation or Reimbursement to Persons Other Than Employees for Professional or Consulting Services in Amounts Less than $500. Enter aggregate of amounts under $500. Indicate whether each item included in total is less than $500. B. Enter itemized information if over $500. You do not have to report any sales tax or tip paid in connection with the expenditure. 4. Other Professional Expenses (Advertising, Public Relations, Catering, etc.) (Sec. 1 8-75(a)(2b)). A. Other Professional Expenses in Amounts Less than $500. Enter total of individual expenses in amounts under $500. Indicate whether eachitem included in total is less than $500. B. Enter itemized information if over $500. You do not have to report any sales tax or tip paid in connection with the expenditure.
2. Total Pages of Activities Schedule C filed. Attach additional copies of the Schedule C page as needed. After you have completed Schedule C, count the total number of pages of Schedule C and write that number in the blank provided. Number each ofthe pages. 3. Expenditures, Gifts and Honoraria 3A. Itemized. You must complete a separate entry on Schedule C for each officer or employee of the executive or legislative branch of City government to whom an expenditure, gift or honorarium of $250 or more was given. Under 3A, provide the following:
Enter date of expenditure. Beneficiary Name. Provide the name of the officer or employee of the executive or legislative branch of City government to whom the expenditure, gift, or honorarium was given. Such items given to a member’s family or other
persons in whose welfare a member is interested should be attributed to the member. (Sec. 18-75(a)(3)). Description of Circumstances of Transaction. Provide a general description of circumstances concerning the expenditure, gift, or honorarium. Do not include expenditures made for attendance of a member at political fund-raisers or charity events. Expenditure Amount. Report the amount spent as an exact amount. You do not have to report any sales tax or tip paid in connection with the expenditure. 3B. AGGREGATE INDiVIDUAL EXPENDITURES, GIFTS, OR HONORARIA OF LESS THAN $250 BUT MORE THAN $25 You must also report the aggregate amount of individual expenditures to benefit a member ofless than $250 but more than $25. Do not include expenditures made for attendance of a member at political fund-raisers or charity events.
Chapter 171, Texas Local Government Code and with which you have engaged in an exchange of money, goods, services or anything of value, totaling $250 or more in a calendar quarter. (Sec. 18-75(a)(4)). Under &#167; 171.002 a person has a substantial interest in a business entity if: (1) the person owns 10% or more of its voting stock or shares or either 10% or more than $5,000 of its fair market value; or (2) funds received from it exceed 10% of the person’s gross income from the previous year; or (3) the person has an equitable interest in or legal ownership of real property with a fair market value of $2,500 or more. A local public official is also deemed to have a “substantial interest” if a person related to the official in the first degree of consanguinity or affinity as shown in Figure 1 has a substantial interest. Section 573.022 of the Texas Government Code provides that an adopted child is considered to be a child of the adoptive parent for this purpose. Section 573.024 provides that the ending of a marriage by divorce or the death of a spouse ends relationships by affinity created by that marriage unless a child ofthat marriage is living, in which case the marriage is considered to continue as long as a child of that marriage lives. 1. Registrant Name. Provide registrant’s name as it appears on Registration Cover Sheet.
Activities Schedule D: Exchanges with Member’s Business Entity
You must also report each business entity in which you know or have reason to believe that a member is a proprietor, partner, director, officer, manager, employer or employee or has a substantial interest within the meaning of
Total Pages of Activities Schedule D Filed. Attach additional copies of the Schedule D page as needed. After you have completed Schedule D, count the total number of pages of Schedule D and write that number in the blank provided. Number each ofthe pages. Exchanges with Member’s Business Entities. List all exchangeswith business entities of money, goods, services or anything of value of $250 or more. Include all exchanges with entities you know or have reason to believe a member is a proprietor, partner, director, officer, manager, employer or employee or has a substantial interest.
Consanguinity Kinship Chart (Blood)
Affinity Kinship Chart (Marriage)
OFFICE OF ‘THE CrrY
P.O. Box 1562 HousToN, TX 77251(713)247-1840
The City of Houston LOBBY REGISTRATION AND REPORTING INSTRUCTION GUIDE explains how to . fill out this form.
NUMBER OF REGISTRATION SCHEDULE A’s FILEDWITH THIS COVER SHEET (1 FOR EACH CLIENT OR SUBJECT)
GRAND TOTAL PAGES FILED CITY SECRETARY’S USE ONLY
2 0 ORIGINAL FILING 0 AMENDED FILING IF ORIGINAL FILING, IS REGISTRATION FEE OF $20 ATTACHED? (PAYABLE TO CITY OF HOUSTON)
DATE AND TIME FILED:
.m. 4
REASON FOR REGISTRATION EXPENDITIJREs OF $200 OR MORE (OPERATIONAL OR TO B~~Fn~ A MEMBER, INCLUDING THOSE LESS THAN $25)? DYES DNO COMPENSATION OR REIMBURSEMENT OF $200 OR MORE? DYES ONO
RECEWr#
IS THE REGISTRANT AN INDIVIDUAL? REGISTRANT’S NORMAL BUSINESS REGISTRANT’S BUSINESS OR RESIDENCE ADDRESS
PERMANENT STREET ADDRESS;
APT/SUITE #;
REGISTRANT’S MAILING ADDRESS SAME AS BUSINESS OR RESIDENCE ADDRESS LISTED ABOVE BUSINESS OR HOME PHONE (OPTIONAL)
STREET ADDRESS/PC) BO)~
IS THE REGISTRANT A LOBBY FIRM EMPLOYEE?
NAME OF FIRM ADDRESS OF FIRM_______________________________________________
PHONE NO. OF FIRM (OPTIONAL)______________________________________
TO THE BEST OF MY KNOWLEDGE THE ACCOMPANYING DoCUMENT (INCLUDINGATTACHED SCHEDULES INDICATED ABOVE, IF ANY) IS TRUE AND CORRECT AND INCLUDES ALLINFORMATION TO BE REPORTED BY ME UNDER ARTICLE V, CHAPTER 18, CODE OF ORDINANCES, HOUSTON, TEXAS.
AFFIX NOTARY STAMP ABOVE
SIGNATURE OF REGISTRANT ,THIS THE DAY OF_________
SWORN TO AND SUBSCRIBED BEFORE ME, THE SAID 19__, TO CERTIFY WHICH, WITNESS MY HAND ANDSEAL OF OFFICE.
SIGNATURE OF OFFICER ADMINISTERING OATH CHANGES IN INFORMA11ON.
TITLE OF OFFICERADMINISTERING OATH
Ifany of the information provided in this Registration or Registration Schedule A changes, you must file a quarterly the changed information between the 1st and 10th day of Januazy, April, July, or October (whichever is sooner).
(713)247-1840
CITY OF HOUSTON LOBBY REGISTRATION FORM— Registration Schedule A ENTITY. EMPLOYER. OR OTHER PERSON REPRESENTEThSUBJIECT MATTER PART 1— GENFI?A1. ~J~flPMATIflN
Use the INSTRUCTION GUIDE for assistance in filling out this form. Submit a separate Schedule A for each person you represent (including yourself, ifapplicable), or ifnone, for each subject matter advanced on behalfofyour own personal interest 1
~ of (TOTAL SCHEDULE A) IS THIS ORIGINAL FILING OR AMENDMENT? o ORIGINAL o AMENDED FILING
REPRESENTING OWN PERSONAL INTEREST ONLY? DYES DN0
NAME OF ENTITY, EMPLOYER, OR OTHER PERSONREPRESEN11ID
ENTITY, EMPLOYER, OR OTHERPERSON’s MAILINGADDRESS
ADDRESS/POBO)~
APT/SUITE 4;
NATURE OF BUSINESS ORORGANIZATION OF ENTITY, EMPLOYER OR OTHER PERSON REPRESENTED
PART 2*_ COMPENSATION OR REIMBURSEMENT TO REGISTRANT
($200 ORMORE 7 8
IN CURRENT CALENDAR QUARTER EXCLUDING OWNPERSONAL EXPENSES)
IfPART 2 is not apnlicaHe. check box. and pp to PART 3.
NATURE OF COMPENSATION OR REIMBURSEMENT FOR LOBBYING
D Not contingenton outcome
Totally contingent on outcome Partially contingent on outcome
STATUS OF COMPENSATION OR REIMBURSEMENT BEING REPORTED
D Already Paid
D Earned (but not received)
INDIVIDUAL REGISTERINGFOR ENTITY
NAME OF ENTITY ADDRESS OF ENTITY PHONENO. OFENTITY_____________________________________________________ (OPTIONAL)
PART 3* REGISTRANT EXPENDITURES TOTALING $200 OR MORE IN CURRENT CALENDAR OUARTER (INCLUD GAMOUNTS ~
HAS REGISTRANTMADE EXPENDITURES OF $200 OR MORE IN CALENDAR QUARTER, INCLUDING AMOUNTS UNDER $25, TO INFLUENCE MUNICIPALLEGISLATION OR
*Jf NEITHER PART 2 NOR PART 3 IS APPLICABLE, REGISTRATION IS NOT REQUIRED.
SEE REVERSE SIDE FOR PART 4- SUBJECT MATTER CATEGORIES
PART 4- SUBJECT MATTER CATEGORIES 12
o o o o o o o o o o o o o o AMUSEMENTS/SPORTS ANIMALS ANNEXATION ARTS o FIRE SAFETY o FLOOD PLAiN o FRANCHISES
(TOTAL REGISTRATION SclrRDuuI A)
DEALERS/STORAGE AVIATION BUILDING REGULATION BUSINESS/COMMERCE CEMETERIES CHARITABLEINONPROFITS CITY AGENCIES, BOARDS, COMMISSIONS CITY EMPLOYEES, OFFICERS, SYMBOLS CITY FINANCES/INVESTMENTS CONTRACTS CRIME CRIMINAL PROCEDURES
o GAMBLING o GOOD WILL/HOSPITALITY
o GRM~rrs/LoANS o HAZARDOUS WASTE o HEALTH/HEALTHCARE o HEALTH CARE PROVIDERS o HISTORIC PRESERVATION
o POLICE o POLITICAL SUBDIVISIONS o PRIVATIZATION o PROPERTY ACQUISITION, SALES,
LEASING PUBLIC ACCESS TELEVISION PURCHASING REDEVELOPMENT (TIFS, PIDS,
TIRZ)
o RECYCLING o REDISTRICTING o RELIGION o RETIREMENT SYSTEMS
o HOUSING/COMMUNITY o o
o DEVELOPMENT HuMAN SERVICES INSURANCE LABOR LAND USE LANDFILLS LAW ENFORCEMENT LIBRARIES LICENSES/PERIVITTS MINORS MOBILE HOMES MuNICIPAL COURTS NEIGHBORHOOD PROTECTION! NUISANCES OCCUPATIONAL REGULATION OIL&amp;GAS
o SAFETY o SEXUALLY ORIENTED BUSINESS o SIGNS
o STREETS/SIDEWALKS o TAxATION
o o TOURISM TRANSPORTATION
o DANGEROUS BUILDINGS DEED RESTRICTIONS DISASTER
PREPAREDNESS/RELIEF o EcONOMIC DEVELOPMENT o EDUCATION o ELECTIONS
o Tow TRUCKS o TRASH/SOLID WASTE
o UTILITIES o VEHICLES &amp; TRAFFIC o VEHICLES FOR HIRE
o WATER, WASTEWATER &amp;
o ENERGY o ENVIRONMENT o ETHICS o FEES/NON-TAX REVENUE
o o OPEN GOVERNMENT o PARKS/RECREATION o PERSONS WITH DISABILiTIES o PLANNING/DEVELOPMENT
CONTRACT OR AGENDA ITEM NOS.,DATE OR OTHER DESIGNATION NOT APPLICABLE ADDITIONAL PAGES
Office ofthe City Secretary
USE THE INSTRUCTION GUIDE FORASSISTANCE IN FILLING OUTTHIS FORM. 1 AMENDED REGISTRATION ATFACHED? DYES ONO AMENDED REGISTRATION SCHEDULES FILED? DYES DNO CORRECTED LOBBY ACTIVITIES REPORT? DYES DNO NUMBER oFAcFIVITY SCHEDULESFILED: A B C D PAGE — OF— (GRAND TOTAL FILED)
ACTiVITIES Cover Sheet 2
REGISTRANTNAME REPORT TYPE (CHECK ONE)
CITY SECRETARY’S USE ONLY
0 FINAL (ATFACH TERMINATION FORMIF NOT ALREADY FILED)
HAS INFORMATIONON ORIGINALREGISTRATIONCHANGED? 0 NO 0 YES (ATrACH AMENDEDLOBBY REGISTRATION FORM) D JANUARY 10 0 JULY
REPORT DEADLINE (CHECK ONE) PERIOD COVERED O JAN. - ~ O APRIL - JUNE OJULY-SEPT.
ENDING MONTH / DAY!YEAR DATE FILED:
BEGINNING MONTH / DAY / Ya~
DOCT. -DEG.
IF FINAL REPORT, GIVEENDING
DATE_________________ DATE PROCESSED:
OPERATIONAL EXPENDITURES FOR DIRECT COMMUNICATION. (OTHER THANBENEFITS REPORTED BELOW IN ITEMS 8 AND 9), BROKEN DOWNINTO CATEGORIES SHOWNIN A AND B.
COMPENSATION/REIMBURSEMENT TOPERSONS OTHER THAN EMPLOYEES FOR PROFESSIONAL OR CONSULTING SERVICES
0 NoNE 0 YES (ATrACH ACTIViTIES SCHEDULEB)
ADDiTIONAL PROFESSIONALEXPENSES FOR DIRECT COMMUNICATION (IF YES, ATTACHACTIVITIES SCHEDULE 1. ADVERTISING ONONE DYES PUBLIC RELATIONS DNONE DYES CATERING DNONE DYES OTHER (LIST TYPE) DNONE DYES
EXPENDITURES, GIFTS AND HONORARIA TO BENEFIT A MEMBER (EXCLUDING THOSEFOR ATTENDANCE AT POLITICAL FUND-RAISERS OR CHARITY EVENTS)
EXPENDITURES, GIFTS OR HONORARIAOF $250 ORMORE (EXCLUDING THOSEFOR ATTENDANCE AT POLITICAL FUND-RAISERS OR CHARITY EVENTS):
DYES (ATTACH ACTIVITIES SCHEDULE C)
EXPENDITURES, GIFTS OR HONORARIA TO BENEFIT A MEMBER, IF LESS THAN $250 BUT MORE THAN CHARITY EVENTS)
$25 (EXCLUDING THOSE FOR POLITICAL FUND-RAISERS AND
INDIVIDUAL REPORTING FOR ENTITY? DYES YOUR
NAME OF ENTITY________________________________________________________________
ADDRESS OF ENTITY PHONE NO. OF ENTITY____________________________________________________________ (OPTIONAL) AREA C0DEJ Nt~iBER IEXTENSION TO THE BEST OF MY KNOWLEDGE THE ACCOMPANYINGDOCUMENT IS TRUE AND CORRECT AND INCLUDES ALL INFORMATION TO BE REPORTED BY ME UNDER ARTICLE V, CHAPTER CODE OF ORDINANCES, HOUSTON, TEXAS.
AFFIX NOTARY STAMP ABOVE SWORN TOAND SUBSCRIBED BEFOREME, THE SAID WHICH,WITNESS MY HAND AND SEAL OF OFFICE.
19_, TO CERTIFY
SIGNATURE OFOFFICER ADMiNISTERING OATH
PRINT NAME OFOFFICER ADMINISTERING OATH
TITLE OFOFFICER ADMINISTERING OATH
OmCE OF THE CITY SECRETARY
Lobby Activities Schedule A
PAGE — OF — (GRAND TOTALFILED)
O AMUSEMENTS/SPORTS ANIMALS ANNEXATION ARTS AUTOMOTIVE
DEALERS/STORAGE
o AvIATION o BUILDiNG REGULATION O BUSINESS/COMMERCE
o CHARJTABLE/NONPROFITS o CITY AGENCIES, BOARDS, COMMISSIONS
FIRE SAFETY FLOOD PLAIN FRANCHISES GAMBLING GOOD WILL/HOSPITALITY GRANTS/LOANS HAZARDOUS WASTE HEALTH/HEALTH CARE HEALTH CARE PROVIDERS
O POLITICAL SUBDIVISIONS O PRIVATIZATION
O PROPERTY AcQuismoN, SALES,
O PURCHASING O REDEVELOPMENT (TIFS, PIDS, TIRZ) O RECYCLING
o REDISTRICTING O RELIGION O RETIREMENT SYSTEMS
O HOUSING/COMMUNITY DEVELOPMENT o HUMAN SERVICES
o CITY EMPLOYEES, OFFICERS,
CITY FINANCES/INVESTMENTS
o INSURANCE o LABOR o LAND USE
SPECIAL DISTRICTS STREETS/SIDEWALKS TAXATION TOURISM
o CONT1~ACTS
OCRIIvIE o CRllvffl’.TAL PROCEDURES
o LAW ENFORCEMENT o LIBRARIES o LICENSES/PERMITS
o DANGEROUS BUILDINGS O DEED RESTRICTIONS o DISASTER
PREPAREDNESS/RELIEF
O MINORS o MOBILE HOMES
O Tow TRUCKS O TRANSPORTATION
O TRASH/SOLID
O NEIGHBORHOOD PROTECTION!
o UTILITIES o VEHICLES &amp; TRAFFIC
O o o o o ENERGY
ENVIRONIvIENT ETHICS FEES/NoN-TAX REVENUE FIRE FIGHTERS
O OCCUPATIONAL REGULATION
O o o o o OIL&amp;GAS OPEN GOVERNMENT
PARKS/RECREATION PERSONS WITH DISABILITIES PLANNING/DEVELOPMENT
O VEHICLES FOR HiRE O WATER, WASTEWATER &amp;
SEWERS O OTHER_______________
CONTRACT, AGENDA ITEM,DOCKET NOS. OR OTHER DESIGNATION 0 NOTAPPLICABLE ADDITIONALPAGES
DEPARTMENT OR OTHER DESIGNATION
LOBBY AcnvrnEs Scii~ui~
REGISTRANT NAME OPERATIONALEXPENSES FOR DIRECT COMMUNICATION OTHER THANBENEFITS TOMEMBERS
TOTAL COMPENSATIONOR REIMBURSEMENT TOPERSONS (OTHER THAN EMPLOYEES)FOR PROFESSIONAL OR CONSULTING SERVICES IN AMOUNTS LESS THAN $500 TOTAL
THE AMOUNT OF EACH ITEM LESS THAN $500?
FoR PERSONS (OTHER THANEMPLOYEES) COMPENSATED OR REIMBURSED IN AMOUNTS OF $500 OR MORE
NAME/TITLE OF RECIPIENT
PERSON COMPENSATED OR REIMBURSED
(CITY OFFICIAL, EMPLOYEE, ~ FAMILY MEMBER. IF APPLICABLE~
OTHER PROFESSIONAL EXPENSES, INCLUDING BUT NOTLIMITED TO ADVERTISING, PUBLIC RELATIONS AND CATERING
TOTAL OF INDIVIDUAL EXPENSES OF LESS THAN $500 TOTAL
IS THE AMOUNT OF EACH ITEM LESS THAN $500?
PERSONS COMPENSATED OR REIMBURSED IN AMOUNTS OF $500 OR MORE NAME/TITLE OF RECIPIENT
(CITY OFFICIAL, EMPLOYEE, ~ FAMILY MEMBER. IF APPLICABLE)
LOBBY Acrivrrnls Scm~’rniuI C
ExP~orruREs, GWrS, AND HONORARIATO BENEFiT A MEMBER
1 REGISTRANT NAME
ITEMIZED EXPENDITURES, GIFTS AND HONORARIA OF $250 OR MORE TO BENEFIT A MEMBER (DO NOT INCLUDE THOSE FORATTENDANCE AT A POLITICAL FUNDRAISER OR CHARITY EVENTS.) BENEFICIARY CIRCUMSTANCES OF TRANSACTION AMOUNT
3B AGGREGATE OF INDIVIDUAL EXPENDITURES, GIFTS AND HONORARIALESS THAN $250 BUT MORE THAN $25 TO BENEFIT A MEMBER (DO NOT INCLUDE THOSEFOR ATTENDANCE ATPOLITICAL FUND-RAISERS OR CHARITY EVENTS) BENEFICIARY AGGREGATE AMOUNT TO EACH BENEFICIARY
OF THE CITY SECRETARY
EXCHANGES WITH MEMBER’S BUSINESS ENTITIES
LOBBY AcTIvmEs Sci~r)ui~ D
EXCHANGES OF $250 OR MORE WITH BUSINESS IN WHICHMEMBER IS OR MAYBE SUBSTANTIALLLY INTERESTED UNDER CH.
171 TEXAS LOCAL
GOVERNMENT CODE OR OF WHICH A MEMBER IS A PROPRIETOR, PARTNER, DIRECTOR, OFFICER, MANAGER, EMPLOYER OR EMPLOYEE
OFUCE OF Thil CITY SECRETARY
CITY OF HOUSTON LOBBY TERMINATION NOTICE Account #
CITY SECRETARY’S OFFICE USE ONLY A REGISTRANTUNDER ARTICLE
CHAFFER 18 OF THE CODE OF ORDINANCES, HOUSTON, TEXAS, HEREBY STATE AS OF THE FILING OF THIS NOTICE IHAVE CEASED TO ENGAGE IN ALL ACTIVITIES REQUIRiNG REGISTRATION UNDER CHAPTER 18. IACKNOWLEDGE THAT JAM REQUIRED TOFILE A LOBBYACTIVITIES REPORT FOR ANY PERIOD DURING WHICH I WAS REGISTERED, ENGAGED IN REPORTABLE ACTIVITIES AND FOR WHICHI HAVE NOT ALREADY FILEDSUCH REPORT.
SIGNATURE OF REGISTRANT TimE (IFANY) DATE PROCESSED: ,THIS THE DAY OF
SWORN TOAND
SUBSCRIBED BEFORE ME, BY THE SAID
AFFIXNOTARY SYEMP/SEAL BREOw
TO CERTIFY WHICH,WITNESS MY HAND AND SEAL OF OFFICE.
SIGNATERE OF OFRCER ADMINISTERINGOATh
PRINTNAME OFOFFICERADMINISTERING OATh
ThEE OFOFFICER ADMINISTERINGOATh
BEFORE YOU TERMINATE YOUR LOBBY REGISTRATION
A Final Lobby Activities Report must be filed at the time of filing this Termination Notice or by the next following quarterly reporting deadline. The final report should report all lobby activities from the day after the period covered by your last Lobby Activities Report through the termination date (the date the Lobby Termination Notice is filed with the Office of the City Secretary. (Sec. 18-77(b)).
Note: The ending datefor the “Period Covered” on your Lobby Activities Report (question 6 on Activities Cover Sheet) should be the same asyour termination date, the date the termination notice isfiled TERMINATION NOTICE A termination form should not be filed unless you have entirely ceased your lobby activity for the remaining portion of your current annual registration. You should not file this form if you have ceased lobbying for one employer or client but you continue to, or may, lobby on behalf of others during the remaining portion of your annual registration period.
EXPIRED REGISTRATION All lobby registrations expire at midnight one year from the date of filing unless renewed or terminated at an earlier date. You are not required to file this form unless you want to terminate your registration before your registration expires.
SIGNATURE The termination notice must be signed by the individual registrant as it appears on the Registration Form, or, ifthe registrant is a business, by a person whose actions legally bind the organization, such as the owner, an officer, or a director.
UNFILED REPORTS Filing a termination form does not relieve you from your obligation to file any unfiled reports due.