EXECUTIVE LOBBYING EMPLOYER/PRINCIPAL'S EXPENDITURE REPORT Form 508 [] COVERING JANUARY 1 THROUGH JUNE 30, _____ - DUE AUGUST 15 [] COVERING JANUARY 1 THROUGH DECEMBER 31, _____ - DUE FEBRUARY 15 |
Pursuant to LSA-R.S. 49:76G(2)(a), an employer or principal of a lobbyist may elect to file the Lobbying Expenditure Reports as required by Title 49 on behalf of all of its lobbyists. This reporting form is to be used by principals or employers who have exercised this option by timely filing the Executive Lobbying Expenditure Reporting Designation Form and are reporting on behalf of their registered executive lobbyists. |
Hand deliver or mail to : 2415 Quail Drive , 3rd Floor, Baton Rouge , LA 70808 OR Fax to : (225) 763-8787 or (225) 763-8780 |
FOR OFFICE USE ONLY Postmark Date_________ |
Street and No. City State Zip
MAILING ADDRESS _______________________________________________________________
Street and No. City State Zip
Last First MI
(If different from above) Street and No. City State Zip
Area Code and Phone Number
Last First MI
Last First MI
Last First MI
Page 1 of ______
Last First MI
Last First MI
Last First MI
Last First MI
Last First MI
Last First MI
Last First MI
(Include expenditures from Schedules A and B)
(When applicable) (Include expenditures from Schedules A and B)
(Line "a" added to Line "b" should equal Line "c")
CERTIFICATION OF ACCURACY
I hereby certify that the information contained herein is true and correct to the best of my knowledge, information and belief; and that no information required by LSA-R.S. 49:71 et seq. has been deliberately omitted.
_______________________________________
Signature of Employer/Principal or Representative
________________________________________
Print or Type Full Name
Executive Lobbyist: ________________________________________________________________ Exec. ID # _____________
Last First MI
SCHEDULE A: EXPENDITURES FOR EXECUTIVE BRANCH OFFICIALS | ||||
This schedule must be completed if during the period January 1 through June 30 or the period July 1 through December 31, one of your registered executive lobbyists made either a) an expenditure for any executive branch official exceeding $50 on any one occasion or b) aggregate expenditures exceeding $250 for any one executive branch official during a reporting period, then you must provide the aggregate total of expenditures made on that individual in that reporting period. Make as many copies as are necessary. Each lobbyist should have his own Schedule A if one is required. NOTE: Report covering July - December is cumulative. You must include reportable expenditures from the first half of the year in Column #3. | ||||
1. EXECUTIVE OFFICIAL'S NAME | 2. OFFICIAL'S AGENCY AS LISTED IN THE EXECUTIVE BRANCH SCHEDULE | 3. AMOUNT OF EXPENDITURES MADE ON AN OFFICIAL FOR WHOM YOU EITHER SPENT OVER $50 ON ONE OCCASION OR MADE EXPENDITURES EXCEEDING $250 BETWEEN JANUARY 1 AND JUNE 30 | 4. AMOUNT OF EXPENDITURES MADE ON AN OFFICIAL FOR WHOM YOU EITHER SPENT OVER $50 ON ONE OCCASION OR MADE EXPENDITURES EXCEEDING $250 BETWEEN JULY 1 AND DECEMBER 31 | 5. TOTAL OF COLUMNS 3 AND 4 |
SCHEDULE B: EXPENDITURES FOR RECEPTIONS, ETC. | |||
This Schedule must be completed if on of your executive lobbyists expended funds for any receptions, social gatherings, or other functions to which more than twenty-five executive branch officials were invited. List the name of the group or groups invited, the date of the event, physical location of the event including the city, and the total amount expended. Make as many copies as are necessary. Each lobbyist should have his own Schedule B if one is required. | |||
1. NAME(S) OF GROUP(S) INVITED | 2. DATE OF RECEPTION | 3. LOCATION OF RECEPTION | 4. TOTAL AMOUNT OF EXPENDITURES |
EXECUTIVE LOBBYING EMPLOYER/PRINCIPAL'S EXPENDITURE REPORT ATTACHMENT |
This attachment is to be used to complete Item #8 of Form 508, the report form for principals and employers who have elected to report on behalf of their executive lobbyists. Make as many copies of this form as needed for the completion of the expenditure report. Identify each page with a number and indicate the total number of page being submitted. |
(Include expenditures from Schedules A and B)
Total of all executive lobbying expenditures made July1 through December 30: $ ________________________________________
(When Applicable) (Include expenditures from Schedules A and B)
Total of all executive lobbying expenditures made during calendar year: $ ________________________________________
(Adding above expenditure lines should equal this total)
From January 1 through June 30? [] Yes [] No
From July 1 through December 31? [] Yes [] No [] NA
If the answer to either question in "B" above is YES, complete Schedule A and attach.
From January 1 through June 30? [] Yes [] No
From July 1 through December 31? [] Yes [] No [] NA
If the answer to either question in "C" above is YES, complete Schedule A and attach.
Yes [] No []
If the answer to "D" above is YES, complete Schedule B and attach.
(When applicable)
(When applicable)
(When applicable)
(When applicable)
(When applicable)
(When applicable)
(When applicable)
(When applicable)
La. Admin. Code tit. 52, § I-2139