Lobbyist_2016_T_Alex Cherin (Cherin Group)_011516 REGEIViijilsta,l,
CITY CLERK
City of Long Beach LCqG L 'ACH. C4
DECLARATION OF TERMINATION 16 JAN ZQ PM ( _l1 _
Download 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: Inc CIS✓;/1 Etre,,D /AAA.-/ Ckvriq / CL))-13--ck3
(Lobbyist Name) (Filer ID number)
Covering dates from: i5 to: %d 1 3 11 15
Section 1- Information About All Filers
(ALL LOBBYISTS MUST COMPLETE SECTION ONE)
PART A. Filer Information:
Name of Filer: 1 lKC Atq t fin,- o h
Business Address:
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Business Fax Number: Jy k
Description of the Nature of your Business or Organization: COO^S Nj
PART B. Verification of Person Responsible for Report Preparation:
Print Name: NkL p CV\.cJ'%4� C C1�`uid1 G-ya--
Title: pwv-cr
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 California that the foregoing is true and correct.
Date: 1TI '6 Signature: `
City of Long Beach Lobbyist Registration Report Form—clb.cc.lbyterm Revised 10/2012 Page 1 of 2
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City of Long Beach
DECLARATION OF TERMINATION
Section 2 - Client Termination Information
All Declarations of Termination must list all client lobbying activities that occurred between the end of the last semi-annual reporting endd and the date of the termination.
Nature of city
Client Name Client Address Telephone Number Business Official/Employee
li Contacted
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Filer name: 1�—c C V\wt h C��` Pf\vn C InC✓t ✓� Filer ID Number C L l3 )3-c a` 3 Date 5 -G
City of Long Beach Lobbyist Registration Report Form—clb.cc.lbyterm Revised 10/2012 Page 2 of 2