Lobbyist Registration Form - City of Santa Ana

Lobbyist / Lobbying Firm Name * Required
Mailing address of Lobbyist / Lobbying Firm * Required
Street Address Address Line 2 City State ZIP Code
Email address of Lobbyist / Lobbying Firm * Required
Phone number of Lobbyist / Lobbying Firm
Names of all owners of the Lobbyist / Lobbying Firm * Required
Names of each individual lobbyist * Required
Description of the nature of the business entity or corporation (the Lobbyist / Lobbying Firm) * Required
The name, business address, telephone number, and email address of each client receiving lobbying services
The nature of each client's business * Required
A brief description of the governmental decision that the lobbyist seeks to influence on each client's behalf, the desired outcome, and the names of the officials the lobbyist has contacted on each client's behalf * Required
The name of each person employed or retained by the lobbyist to engage in lobbying activities on each client's behalf * Required
The date, amount, and description of any payment made to, or on behalf of, any City official or member of an official's family (note: payments to be disclosed include gifts, meals, fees, salaries, and any other form of compensation or renumeration) * Required
CAPTCHA
Online disclosure of report forms and reports * Required
I agree that I am a duly authorized owner or officer of the Lobbyist / Lobbying Firm, I have reviewed the contents of this form, and I verify under penalty of perjury that I believe the contents of this form are true, correct, and complete based on personal knowledge or on information and belief.