La. Admin. Code tit. 52 § I-1908
LOBBYING EXPENDITURE REPORT COVERING JANUARY 1 THROUGH JUNE 30, ___ DUE BY AUGUST 15 COVERING JULY 1 THROUGH DECEMBER 31, __ DUE BY FEBRUARY 15 |
_____________________ Lobbyist's Registration Number |
FOR OFFICE USE ONLY Postmark Date:______ |
Instructions
· Print in ink or type.
· Fill in registration number in spaces provided.
· Check the box that identifies which report is being filed and fill in the year that the
report is covering in the space provided.
· Complete form and return to the Board of Ethics, 2415 Quail Dr., 3rd Floor,
Baton Rouge, LA 70808 (225) 763-8777 or (800) 842-6630
· This form must be delivered or postmarked by the due date.
· This form may be faxed to (225) 763-8787.
· The report covering July 1-Dec.31 is a cumulative report. You must include information from the first half of the year.
1. NAME_____________________________________________________
Last First MI
2. BUSINESS ADDRESS____________________________________________________________
Street and No. City State Zip
MAILING ADDRESS_____________________________________________________________
Street and No. City State Zip
3. BUSINESS PHONE___________________________________________
Area Code and Phone Number
4. Total of all expenditures made January 1 through June 30: $ __________________________
(Include expenditures from Schedules A and B)
5. Total of all expenditures made July 1 through December 31: $.__________________________
(When applicable) (Include expenditures from Schedules A and B)
6. Total of all expenditures made during calendar year: $ __________________________
(Line 4 added with Line 5 should equal Line 6)
7. Did you make an expenditure exceeding $50 on one occasion for any one legislator:
From January 1 through June 30 [] YES []NO
From July 1 through December 31 [] YES []NO []NA
If the answer to either question in Number 7 above is YES, please complete Schedule A and attach.
8. Did you make expenditures exceeding the sum of $250 for any one legislator:
From January 1 through June 30 [] YES []NO
From July 1 through December 31 []YES []NO []NA
If the answer to either question in Number 8 above is YES, please complete Schedule A and attach.
9. Did you expend funds for a reception, social gathering, or other function to which the entire legislature, either house, any standing committee, select committee, statutory committee, committee created by resolution of either house, subcommittee of any committee, recognized caucus, or any delegation thereof were invited during this reporting period?
[]YES []NO
If the answer to either question in Number 9 above is YES, please complete Schedule B and attach.
CERTIFICATION OF ACCURACY
I hereby certify that the information contained herein is true and correct to the best of my knowledge, information, and belief; that all reportable expenditures have been included herein; and that no information required by the Lobbyist Disclosure Act [LSA-R.S. 24:50 et seq.] has been deliberately omitted.
_________________________________________
Signature of Lobbyist
SCHEDULE A: EXPENDITURES FOR LEGISLATION | |||
This schedule must be completed if you answered YES to either question 7 or 8 on the Lobbying Expenditure Report. If, during the period January 1 through June 30 or the period July 1 through December 31, you made either (a) an expenditure for any one legislator exceeding $50 on any one occasion or (b) aggregate expenditures exceeding $250 for any one legislator during a reporting period, then you must provide the aggregate total of expenditures made on that legislator in that reporting period. NOTE: Report covering July-December is cumulative. You must include reportable expenditures from the first half of the year in Column #2. | |||
1. LEGISLATOR'S NAME | 2. AMOUNT OF EXPENDITURES MADE ON A LEGISLATOR FOR WHOM YOU EITHER SPENT OVER $50 ON ONE OCCASION OR MADE EXPENDITURES EXCEEDING $250 BETWEEN JANUARY 1 AND JUNE 30. | 3. AMOUNT OF EXPENDITURES MADE ON A LEGISLATOR FOR WHOM YOU EITHER SPENT OVER $50 ON ONE OCCASION OR MADE EXPENDITRES EXCEEDING $250 BETWEEN JULY 1 AND DECEMBER 31. | 4. TOTAL OF COLUMNS 2 AND 3. |
SCHEDULE B: EXPENDITURES FOR RECEPTIONS, ETC. | |||
This schedule must be completed if you answered YES to either question 9 on the Lobbying Expenditure Report. The following information must be provided for all receptions, social gatherings, or other functions to which the entire legislature, either house, any standing committee, select committee, statutory committee, committee created by resolution of either house, subcommittee of any committee, recognized caucus, or any delegation thereof, was invited. | |||
1. NAME(S) OF GROUP(S) INVITED | 2. DATE OF RECEPTION | 3. LOCATION OF RECEPTION | 4. TOTAL AMOUNT OF EXPENDITURES FOR ATTENDING LEGISLATORS* |
* No amount expended on persons other than attending legislators is reportable.
La. Admin. Code tit. 52, § I-1908