CITY CLERK'S OFFICE LOBBYIST INITIAL/ANNUAL REGISTRATION REPORT INSTRUCTIONS: Complete and return this form, along with your payment, to: FEES DUE: Initial/Annual Registration - $452.00 per Registrant plus $64.00 per Client On or after June 30 - $213.00 per Registrant pius $64.00 per Client CITY OF IRVINE City Clerk's Office One Civic Center Plaza Irvine, CA 92623-9575 CHECK APPLICABLE BOX: o INITIAL REGISTRATION - I/We qualified as a lobbyist on r,...) ------- U1 A person engaging in lobbyist activities must file an Initial Report within 30 days of the date he/she receives or becomes entitled to receive $10,000 or more in compensation from a Client in a calendar quarter, or prior to the date therbject matter of the lobbying activity is scheduled for official City action, whichever is sooner. [0' ANNUAL REGISTRATION - Due January 31st for Registrants and all active Clients. SECTION 1 - REGISTRANT LOBBYIST INFORMATION NAME OF REGISTRANT LOBBYIST BUSINESS PHONE PC\ub~\ PvbilL A Ha'(~ - /Qo,0er FCtlJ0-ej (Cl4q) 7 hg - IIoDD BUSINESS ADDRESS - BUSINESS FAX 2r; OrGhlArd (ct LlCf) 7~~-1 tt, 0 \ CITY STATE ZIP BUSINESS E-MAIL L-lI\ le Fore s-\- (f\ Q2b)O Ie Fc'(u he I @ft4 ubel publl'lu\ffc4i'(~ " Ofh DESCRIBE NATURE OF YOUR BUSINESS Q, 0 vern mer\ tt/1 I Aftt'lI(S ~ PJoh c QtlC1tionS NAME/POSITION OF EACH CITY OFFICIAL OR CITY OFFICIAL'S RELATIVE WHO IS EMPLOYED BY THE REGISTRANT NJR IF REGISTRANT OR EMPLOYEE OF REGISTRANT IS A FORMER CITY OFFICIAL OR EMPLOYEE, LIST POSITION(S) HELD DURING THE PAST YEAR -----._-_.._-_. NJA I AM FAMILIAR WITH THE PROVISIONS OF SECTION 1-6-107 OF THE IRVINE MUNICIPAL CODE. MY LOBBYING ACTIVITIES Wlt[ NOT VIO ATE THOSE PROVISIONS. L----=~~:;?f~~«~~~~~~~ TlTLE(i~~ DA#/O FORM 10-05 REV 01/10
i LOBBYIST INITIAL/ANNUAL REGISTRATION REPORT SECTION 2 - REGISTRANT'S CLIENT INFORMATION Complete this section to: 1. Provide information for each new Client since your last report filed. -AND/OR- 2. Report any changes in information for each existing Client since your last report filed. This page may be duplicated for each Client. SELECT ONE: o NEW CLIENT o ;fisitng CLIENT cino NEW INFORMATION TO REPORT CLIENT NAME -- - PHONE - ADDRESS DESCRIBE NATURE OF CLIENT'S BUSINESS CITY STATE ZIP NAME OF PERSON, OTHER THAN CLIENT. ON WHOSE BEHALF REGISTRANT HAS BEEN ENGAGED BY CLIENT TO LOBBY NAME OF ANY PERSON, KNOWN BY REGISTRANT, TO CONTRIBUTE FINANCIALLY TO THE COMPENSATION OF REGISTRANT, OR IN MAJOR PART PLANS, SUPERVISES, OR CONTROLS REGISTRANT'S LOBBYING ACTIVITIES ON BEHALF OF CLIENT - NAME OF LOBBYING FIRM FOR WHICH REGISTRANT IS AN AGENT OR EMPLOYEE WITH RESPECT TO CLIENT - NAME OF EACH AGENT OR EMPLOYEE OF REGISTRANT EXPECTED TO ACT AS A LOBBYIST ON BEHALF OF CLIENT BRIEF DESCRIPTION OF ALL MUNICIPAL QUESTIONS (as defined by Irvine Municipal Code Section 1-7 -102) REGISTRANT WILL FORSEEABL Y LOBBY FOR ON BEHALF OF CLIENT - PAGE 2 FORM 10-05 REV 01/10
'". LOBBYIST INITIAL/ANNUAL REGISTRATION REPORT SECTION 3 VERIFICATION OF REGISTRANT I HAVE USED ALL REASONABLE DILIGENCE IN PREPARING THIS REPORT AND EACH OF THE SECTIONS HEREOF, AND I HAVE PERSONAL KNOWLEDGE OF THE MATTERS CONTAINED IN THIS REPORT. I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FORGOING IS TRUE AND COR.~_ ~~~~~~_~~~~~~~~~f~~_w ~~~~ TITLE (if representing firm) ~ NOTE: A Basic Guide to Lobbying Registration and Disclosure in the City of Irvine, and the required registration and reporting forms are available by calling the City Clerk's Office at (949) 724-6205, or online at www.ci.irvine.ca.us. PAGE 3 FORM 10-05 REV 01/10
CITY CLERK'S OFFICE LOBBYIST QUARTERLY REPORT OF ACTIVITY INSTRUCTIONS: Complete and return this form to: CITY OF IRVINE City Clerk's Office P.O. Box 19575 Irvine, CA 92623-9575 CHECK APPLICABLE REPORTING PERIOD: Due April 15 (January 1 - March 31) o Due July 15 (April 1 - June 30) ~e October 15 (July 1 - September 30) o Due January 15 (October 1 - December 31) This report is required for lobbying activities for each Client for which compensation of $10,000 or more was received during the applicable calendar quarter. There is no fee due with quarterly reports. However, if the report is not filed by the due date, it will be subject to a $1 O/day delinquency fee per City Council Resolution 06-26. I AM FAMILIAR WITH THE PROVISIONS OF SECTION 1-6-107 OF THE IRVINE MUNICIPAL CODE. ACTIVITIES OT VIOLATE THOSE PROVISIONS. MY LOBBYING FORM 10-01 REV 03/1 0 PAGE 1 of4
, LOBBYIST QUARTERLY REPORT OF ACTIVITY 1. Provide information for each new Client since your last report filed. -AND/OR- 2. Report any changes in information for each existing Client since your last report filed. This page may be duplicated for each Client. D NEW CLIENT ~SITNG CLIENT am/f1d/c,//j- - ~/U/ A/1J. /V,e. ~L/cE 91/2f~r)C' ~~&t$',g~,e Mrt!ll!Z.- L%/e,?' ~C6?t-,vO?o~ffi2-- 91lGs;/,Z /VT FORM 10-01 REV 03/1 0 PAGE 2 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY Complete this section to: 1. Provide information for each new Client since your last report filed. D NEW CLIENT -AND/OR- 2. Report any changes in information for each existing Client since your rn<xisitng CLIENT last report filed. This page may be duplicated for each Client. D NO NEW INFORMATION TO REPORT 0/ /2 ~~6L/ n:- /I/O L.t9/l1ff?r /}-t?j;, :6/t/T FORM 10-01 REV 03/10 PAGE2of4
Iii' LOBBYIST QUARTERLY REPORT OF ACTIVITY 1. Provide information for each new Client since your last report filed. -AND/OR- Report any changes in information for each existing Client since your last report filed. This page may be duplicated for each Client. ~NGCLlENT D NO NEW INFORMATION TO REPORT FORM 10-01 REV 03/1 0 PAGE 2 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY Lobbying activities must be reported for each Client for which compensation of $10,000 or more was received during the calendar quarter in question. Identify the Client represented. List all issues, including municipal questions, upon which lobbying activities were engaged, including, a list of specific legislative proposals and other proposed, pending or completed official actions that occurred during this reporting period. This page may be duplicated as needed. FORM 10-01 REV 03/1 0 PAGE 3 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY Lobbying activities must be reported for each Client for which compensation of $10,000 or more was received during the calendar quarter in question. Identify the Client represented. List all issues, including municipal questions, upon which lobbying activities were engaged, including, a list of specific legislative proposals and other proposed, pending or completed official actions that occurred during this reporting period. This page may be duplicated as needed. FORM 10-01 REV03/10 PAGE 3 of4
p; '. LOBBYIST QUARTERLY REPORT OF ACTIVITY Lobbying activities must be reported for each Client for which compensation of $10,000 or more was received during the calendar quarter in question. Identify the Client represented. List all issues, including municipal questions, upon which lobbying activities were engaged, including, a list of specific legislative proposals and other proposed, pending or completed official actions that occurred during this reporting period. This page may be duplicated as needed. FORM 10-01 REV 03/1 0 PAGE 3 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY I HAVE USED ALL REASONABLE DILIGENCE IN PREPARING THIS REPORT AND EACH OF THE SECTIONS HEREOF, AND I HAVE PERSONAL KNOWLEDGE OF THE MATTERS CONTAINED IN THIS REPORT. I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT. NOTE: A Basic Guide to Lobbying Registration and Disclosure in the City of Irvine, and the required registration and reporting forms are available by calling the City Clerk's Office at (949) 724-6205, or online at www.ci.irvine.ca.us. FORM 10-01 REV 03/10 PAGE4of4
CITY CLERK'S OFFICE INSTRUCTIONS: Complete and return this form to; CHECK APPLICABLE REPORTING PERIOD: D Due April 15 (January 1 - March 31) [Q--Due July 15 (April 1 - June 30) D Due October 15 (July 1 - September 30) D Due January 15 (October 1 - December 31) LOBBYIST QUARTERLY REPORT OF ACTIVITY CITY OF IRVINE City Clerk's Office P.O. Box 19575 Irvine, CA 92623-9575 -- =,-.j = en This report is required for lobbying activities for each Client for which compensation of $1 0,000 or more was received during the applicable calendar quarter. There is no fee due with quarterly reports. However, if the report is not filed by the due date, it will be subject to as 1 O/day delinquency fee per City Council Resolution 06-26. I AM FAMILIAR WITH THE PROVISIONS OF SECTION 1-6-107 OF THE IRVINE MUNICIPAL CODE. ACTIVITIE OT VIOLATE THOSE PROVISIONS. MY LOBBYING DATE FORM 10-01 REV 03/1 0 PAGE1of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY this section to: 1. Provide information for each new Client since your last report filed. 2. Report any changes in information for each existing Client since your last report filed. This page may be duplicated for each Client. -AND/ORo NEW CLIENT ~ISITNG CLIENT ~W INFORMATION TO REPORT S77t7Zl~ tjr- M! -,A/ # h/ Cb/J//~Ac.T,.e,rp ~/// k,l!!8fas6d, FORM 10-01 REV 03110 PAGE 2 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY mplete this section to: 1. Provide information for each new Client since your last report filed. -AND/OR- 2. Report any changes in information for each existing Client since your last report filed. This page may be duplicated for each Client. o NEW CLIENT ~TNGCLlENT ~EW INFORMATION TO REPORT /lff!'il/b /t/gl/c /7JC~fS,/cP ~t>4//70ft' Cl:J.d/5//2~,c7/~A/ j?/z'9;zss fr 'Me Lj'r-<'Ci-r ~/L- /~ff# 3/~C7t/~ /!/Gep<S_.,4,;zd. uat::kr$t/?~ FORM 10-01 REV 03/10 PAGE 2 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY ete this section to: 1. Provide information for each new Client since your last report filed. -AND/OR- Report any changes in information for each existing Client since your last report filed. ~SITNG CLIENT ~ NEW INFORMATION TO REPORT FORM 10-01 REV 0311 0 PAGE 2 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY SECTION 3 - LOBBYING ACTIVITIES - Lobbying activities must be reported for each Client for which compensation of S 10,000 or more was received during the calendar quarter in question. Identify the Client represented. List all issues, including municipal questions, upon which lobbying activities were engaged, including, a list of specific legislative proposals and other proposed, pending or completed official actions that occurred during this reporting period. This page may be duplicated as needed. FORM 10-01 REV 0311 0 PAGE 3 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY SEC T ION 3 '- LOB B YIN G ACT I V I TIE S ',' - ' Lobbying activities must be reported for each Client for which compensation of $10,000 or more was received during the calendar quarter in question. Identify the Client represented. List all issues, including municipal questions, upon which lobbying activities were engaged, including, a list of specific legislative proposals and other proposed, pending or completed official actions that occurred during this reporting period. This page may be duplicated as needed. FORM 10-01 REV 03/1 0 PAGE 3 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY SECTION 4 - VERIFICATION OF REGISTRANT I HAVE USED ALL REASONABLE DILIGENCE IN PREPARING THIS REPORT AND EACH OF THE SECTIONS HEREOF, AND I HAVE PERSONAL KNOWLEDGE OF THE MATTERS CONTAINED IN THIS REPORT. K-I"-I'"IVJH..TY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS DAt ~ ) NOTE: A Basic Guide to Lobbying Registration and Disclosure in the City of Irvine, and the required registration and reporting forms are available by calling the City Clerk's Office at (949) 724-6205, or online at www.clirvine.ca.us. FORM 10-01 REV 03/10 PAGE4of4
~, i{tcu VElJ CITY OF IRVINE I:!T'( CLEg~ OEPl. LOBBYIST QUARTERLY Q~R~eRTpQf. ACTIVITY CITY CLERK'S OFFICE INSTRUCTIONS: Complete and return this form to: CHECK APPLICABLE REPORTING PERIOD: [J?'6ue April 15 (January 1 - March 31) D Due July 15 (April 1 - June 30) D Due October 15 (July 1 - September 30) D Due January 15 (October 1 - December 31) CITY OF IRVINE City Clerk's Office P.O. Box 19575 Irvine, CA 92623-9575.", = 0:::>.1> -" :::0 Ul :x "..-.r- -..I ~, ~ ::=:' -<~-.. n-(;::;'~, roc;,...""m :::0 - ::s::::o< ' rr; 0<0 f't1;z -0,..." ~ This report is required for lobbying activities for each Client for which compensation of $10,000 or more was received during the applicable calendar quarter. There is no fee due with quarterly reports. However, if the report is not filed by the due date, it will be subject to a S 1 O/day delinquency fee per City Council Resolution 06-26. I AM FAMILIAR WITH THE PROVISIONS OF SECTION 1-6-107 OF THE IRVINE MUNICIPAL CODE. ACTIVITIES OT VIO TE THOS OVISIONS. MY LOBBYING ~~ S-/Po/LJ OAT FORM 10-01 REV 03/10 PAGE 1 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY this section to: 1. Provide information for each new Client since your last report filed. -ANO/OR- 2. Report any changes in information for each existing Client since your last report filed. This page may be duplicated for each Client. D NEW CLIENT ~ITNG CLIENT D NO NEW INFORMATION TO REPORT Sm;J/.5- Or to/i&v /yew et9/t/r~er KF? UI/ L,C5C K-E~/JS6L), FORM 10-01 REV 03/10 PAGE 2 of4
LOBBYIST QUARTERLY REPORT OF A~TIVITY mplete this section to: 1. Provide information for each new Client since your last report filed. -AND/OR- 2. Report any changes in information for each existing Client since your last report filed. This page may be duplicated for each Client. o NEW CLIENT D EXISITNG CLIENT ~EW INFORMATION TO REPORT ~ fjtt~c /J1eb7ld/fS &A/ Lt3ff.S /3t3" A 3l'd A--L -' FORM 10-01 REV 03/10 PAGE2of4
.. LOBBYIST QUARTERLY REPORT OF A<:;TIVITY ete is section to: 1. Provide information for each new Client since your last report filed. -AND/OR-. Report any changes in information for each existing Client since your last report filed. This page may be duplicated for each Client. ~ITNG CLIENT ~w INFORMATION TO REPORT FORM 10-01 REV 03/10 PAGE2of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY SECTION 3 - LOBBYING ACTIVITIES Lobbying activities must be reported for each Client for which compensation of S 10,000 or more was received during the calendar quarter in question. Identify the Client represented. List all issues, including municipal questions, upon which lobbying activities were engaged, including, a list of specific legislative proposals and other proposed, pending or completed official actions that occurred during this reporting period. This page may be duplicated as needed. FORM 10-01 REV 03/10 PAGE 3 of 4
LOBBYIST QUARTERLY REPORT OF ACTIVITY Lobbying activities must be reported for each Client for which compensation of $10,000 or more was received during the calendar quarter in question. Identify the Client represented. List all issues, including municipal questions, upon which lobbying activities were engaged, including, a list of specific legislative proposals and other proposed, pending or completed official actions that occurred during this reporting period. This page may be duplicated as needed. FORM 10-01 REV 03110 PAGE 3 of4
LOBBYIST QUARTERLY REPORT OF ACTIVITY 'S E C T ION 4 - V E R ff I CAT ION 0 F REG 1ST RAN T " I HAVE USED ALL REASONABLE DILIGENCE IN PREPARING THIS REPORT AND EACH OF THE SECTIONS HEREOF, AND I HAVE PERSONAL KNOWLEDGE OF THE MATTERS CONTAINED IN THIS REPORT. I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND COR T. NOTE: A Basic Guide to Lobbying Registration and Disclosure in the City of Irvine, and the required registration and reporting forms are available by calling the City Clerk's Office at (949) 724-6205, or online at www.ci.irvine.ca.us. FORM 10-01 REV 03/1 0 PAGE4of4