DAKOTA_COMM_2012-IF Date Stamp
City of Long Beach
�3 LOBBYIST INITIAL REGISTRATION REPORT)'; - r 1
12 JUL 16 AH 10:
INSTRUCTIONS
1. Fill out form
2. Sign and date
3. File with the City Clerk by due date with payment enclosed.
Long Beach City Clerk's Office
333 W. Ocean Blvd.
Long Beach, CA 90802
Tel. (562)570-6101
This is the initial registration report for_ A(�� � �(�� / i'
(Lobbyist Na e) Filer ID number
❑ This is an amendment to the initial report filed on
Section 1- Information About All Filers
(ALL LOBBYISTS MUST COMPLETE SECTION ONE)
PART I. Type of Lobbyist:
Wf Contract lobbyist:A person who engages in lobbying on behalf of one or more clients(acting individually or through agents,
associates,employees or contractors)and who has received or has entered into an agreement for compensation of$3,200 or more
("threshold compensation")for engaging in lobbying during any consecutive three-month period. (Complete Sections 1 and
2.)
❑ Business or organization lobbyist: Any business or organization,whose owner(s),officers(s)or employee(s)carry out
lobbying on its behalf,in an aggregate amount of fifty(50)hours or more within any three month period,whether or not such
officers or employees are specifically compensated to engage in lobbying; provided that the activities of officers shall be
considered lobbying only if those officers receive compensation by the business or organization beyond reimbursement for their
reasonable,travel,meals or incidental expenses. (Complete Sections 1 and 3.)
❑ Expenditure lobbyist: A person who makes payments or incurs expenditures of five thousand dollars ($5,000) or more
during any calendar year in connection with carrying out public relations, advertising or similar activities with the intent of
soliciting or urging,directly or indirectly, other persons to communicate directly with any City Official in order to attempt to
influence legislative or administrative action. The five thousand dollar($5,000)threshold shall not include:(a)compensation paid
to contract lobbyists or employees of lobbying;or (b)dues payments, donations, or other economic consideration paid to an
organization,regardless of whether the dues payments,donations or other economic consideration are used in whole or in part to
lobby. (Complete Sections 1 and 4.)
City of Long Beach Lobbyist Initial Registration Report Form—12/23/2010 Page 1 of 5
City of Long Beach
LOBBYIST INITIAL REGISTRATION REPORT
PART II. Filer Information:
Name of Filer: �)6
Business Address:
�� �
Description of the Nature of your Business or Organization: `
Kr)&t/ I0r)-t) G�� �I -Ow-e) L® EM
PART III. Fees Due:
Initial Registration Fee is$100.00 ($50.00 if registered on or after June 301")
Initial Registration total $ JD�00
Each registrant shall also pay$25.00 per client for whom lobbying is undertaken for compensation in excess of$500.00.
Client Registration total: $ j2 120
Total Registration Fee(Initial fee+Client fee) $
Make checks payable to"City of Long Beach",
PART IV. Verification of Person Responsible for Report Preparation:
Print Name: �L�
Title: � � ��
Address: ���-�� �
I have used all reasonable diligence in preparing this report. I have reviewed all the sections and to the best of my
knowledge the information contained herein is true and complete.
I certify under penalty of perjury under the laws of the State of
City of Long Beach Lobbyist Initial Registration Report Form—12/23/2010 Page 2 of 5
City of Long Beach
LOBBYIST INITIAL REGISTRATION REPORT
Section 2 - Client Information —
(List all clients(old and new)for whom lobbying activity occurred during this reporting period)
Client Name Client Address Telephone Nature of City Official Item(s)of legislative or Name(s)of each person
Number Business or Employee administrative action the employed or retained
Contacted lobbyist is seeking to by the lobbyist that
influence on behalf of the lobbied on behalf of
client: client:
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i/ Y B
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Filer name: L Filer ID number: Date: I '
City of Long Beach Lobbyist Initial Registration Report Form—12/17/2010 Page 3 of 5