LOU_BAGLIETTO_2016-Termination Date Stamp
City of Long Beach
DECLARATION OF TERMINATION CITY
Y i Y 0
CLERK A
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Do"Iaad Form
INSTRUCTIONS
1. Fill out form
2. Sign and date
3. Mail to: Long Beach City Clerk's Office
333 W. Ocean Blvd.
Long Beach, CA 90802
Tel. (562) 570-6101
O Lobbyist termination declaration for. Louis G. Baglietto, Jr. / 11-012
(Lobbyist Name) (Filer ID number)
Covering dates from: 1/1/16 to: 1/15/16
Section 1- Information About All Filers
(ALL LOBBYISTS MUST COMPLETE SECTION ONE)
PART A. Filer Information:
Name of Filer: Louis G. Baglietto, Jr.
Business Address:
Business Fax Number:
Description of the-Nature of your Business or Organization: Public Affairs
PART B. Verification of Person Responsible for Report Preparation:
Print Name: Louis G. Baglietto, Jr.
Title: Prinicipal
Address:
!-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. 1 certify under penalty of perjury under the laws of the
State of California that the foregoing is true and correct.
1/15/16
Date. Signature: �
I
City of Long Beach Lobbyist Registration Report Form—clb.cc.lbyterm Revised 10/2012 Page I of 2
City of Long Beach
DECLARATION OF TERMINATION
Section 2 - Client Tefinination Information
Alt Declarations of Termination must list all client lobbying activities that occurred between the end of the last semi-annual reporting eriod and the date of the termination.
Nature of City
Client Name Client Address Telephone Number Business Official/Employee
Contacted
Filer name:
Louis G. Baglietto' Date
Filer [D Number, Jr. 11-012 1/15/16
City of Long Beach Lobbyist Registration Report Form—c1b.cc.1byterm Revised 10/2012 Page 2 of 2