Louisiana Administrative Code › Title 52 - ETHICS › Part I - Board of Ethics › Chapter 19 - Legislative Branch Lobbyist Disclosure Act › Section I-1908 - Lobbying Expenditure Form

Current through Register Vol. 50, No. 6, June 20, 2024
LOBBYING EXPENDITURE REPORT
COVERING JANUARY 1 THROUGH JUNE 30, ___ DUE BY
							 AUGUST 15
COVERING JULY 1 THROUGH DECEMBER 31, __ DUE BY
							 FEBRUARY 15
_____________________
Lobbyist's Registration Number
FOR OFFICE USE ONLY
Postmark Date:______
Instructions
· Print in ink or type.
· Fill in registration number in spaces
				  provided.
· Check the box that identifies which report is being
				  filed and fill in the year that the
report is covering in the space provided.
· Complete form and return to the Board of Ethics,
				  2415 Quail Dr., 3rd Floor,
Baton Rouge, LA 70808 (225) 763-8777 or (800)
				  842-6630
· T
his form must be delivered or postmarked by
				  the due date.
· This form may be faxed to (225) 763-8787.
· The report covering July 1-Dec.31 is a
cumulative report
. You must include
				  information from the first half of the year.
1.
				  NAME_____________________________________________________
Last First MI
2. BUSINESS
				  ADDRESS____________________________________________________________
Street and No. City State Zip
MAILING
				  ADDRESS_____________________________________________________________
Street and No. City State Zip
3. BUSINESS
				  PHONE___________________________________________
Area Code and Phone Number
4. Total of all expenditures made January 1 through June 30:
				  $ __________________________
(Include expenditures from Schedules A and B)
5. Total of all expenditures made July 1 through December 31:
				  $.__________________________
(When applicable) (Include expenditures from Schedules A and
				  B)
6. Total of all expenditures made during calendar year: $
				  __________________________
(Line 4 added with Line 5 should equal Line 6)
7. Did you make an expenditure exceeding $50 on one occasion
				  for any one legislator:
From January 1 through June 30 [] YES []NO
From July 1 through December 31 [] YES []NO []NA
If the answer to either question in Number 7 above is YES,
				  please complete Schedule A and attach.
8. Did you make expenditures exceeding the sum of $250 for
				  any one legislator:
From January 1 through June 30 [] YES []NO
From July 1 through December 31 []YES []NO []NA
If the answer to either question in Number 8 above is YES,
				  please complete Schedule A and attach.
9. Did you expend funds for a reception, social gathering, or
				  other function to which the entire legislature, either house, any standing
				  committee, select committee, statutory committee, committee created by
				  resolution of either house, subcommittee of any committee, recognized caucus,
				  or any delegation thereof were invited during this reporting period?
[]YES []NO
If the answer to either question in Number 9 above is YES,
				  please complete Schedule B and attach.
CERTIFICATION OF ACCURACY
I hereby certify that the information contained herein is
				  true and correct to the best of my knowledge, information, and belief; that all
				  reportable expenditures have been included herein; and that no information
				  required by the Lobbyist Disclosure Act [LSA-R.S.
				  24:50 et seq.] has been deliberately
				  omitted.
_________________________________________
Signature of Lobbyist
SCHEDULE A: EXPENDITURES FOR LEGISLATION
This schedule must be completed if you answered YES
							 to either question 7 or 8 on the Lobbying Expenditure Report. If, during the
							 period January 1 through June 30 or the period July 1 through December 31, you
							 made either (a) an expenditure for any one legislator exceeding $50 on any one
							 occasion or (b) aggregate expenditures exceeding $250 for any one legislator
							 during a reporting period, then you must provide the aggregate total of
							 expenditures made on that legislator in that reporting period.
NOTE:
							 Report covering July-December is cumulative. You must include reportable
							 expenditures from the first half of the year in Column #2
.
1. LEGISLATOR'S NAME
2. AMOUNT OF EXPENDITURES MADE ON A LEGISLATOR FOR
							 WHOM YOU EITHER SPENT OVER $50 ON ONE OCCASION OR MADE EXPENDITURES EXCEEDING
							 $250
BETWEEN JANUARY 1 AND JUNE 30.
3. AMOUNT OF EXPENDITURES MADE ON A LEGISLATOR FOR
							 WHOM YOU EITHER SPENT OVER $50 ON ONE OCCASION OR MADE EXPENDITRES EXCEEDING
							 $250
BETWEEN JULY 1 AND DECEMBER 31
.
4. TOTAL OF COLUMNS 2 AND 3.
SCHEDULE B: EXPENDITURES FOR RECEPTIONS, ETC.
This schedule must be completed if you answered YES
							 to either question 9 on the Lobbying Expenditure Report. The following
							 information must be provided for all receptions, social gatherings, or other
							 functions to which the entire legislature, either house, any standing
							 committee, select committee, statutory committee, committee created by
							 resolution of either house, subcommittee of any committee, recognized caucus,
							 or any delegation thereof, was invited.
1. NAME(S) OF GROUP(S) INVITED
2. DATE OF RECEPTION
3. LOCATION OF RECEPTION
4.
TOTAL AMOUNT OF EXPENDITURES FOR ATTENDING
							 LEGISLATORS*
* No amount expended on persons other than attending
				  legislators is reportable.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  42:1134(A).