LOBBY ACTIVITIES REPORT 1 Use the FORM LA INSTRUCTION GUIDE for assistance in filling out this form. 2 4 REGISTRANT NAME REPORT TYPE Number of Pages of Schedules Filed: Schedule A Filed: Yes No FORM LA COVER SHEET 3 Filer ID PAGE # B ____ C ____ D ____ E ____ F ____ G ____ OFFICE USE ONLY REGULAR (Monthly) MODIFIED (Annual) EXCEEDED $1000 FINAL (Attach Form TN) 5 REPORT DEADLINE February 10 March 10 April 10 May 10 June 10 July 10 August 10 September 10 October 10 November 10 December 10 January 10 HD / PM Receipt # Legal Amount $ Totals 6 PERIOD COVERED Month BEGINNING Day Year Month ENDING Day Year Date Processed Date Imaged / 7 EXPENDITURE TOTALS BY TYPE $0.00 / THROUGH / / Transportation & Lodging $ ____________________ Gifts (other than awards & mementos) $ ____________________ Food & Beverages $ ____________________ Awards & Mementos $ ____________________ Entertainment $ ____________________ Political Fundraisers/Charity Events $ ____________________ Mass Media Communications $ ____________________ $ ____________________ 8 EXPENDITURE TOTALS BY PERSONS BENEFITTED $0.00 State Senators $ ____________________ Executive Agency Employees Immediate Family of Legislative/ Executive Branch Member Events to Which All Legislators Are Invited Guests State Representatives Other Elected/Appointed State Officers Legislative Branch Employees $ ____________________ $ ____________________ $ ____________________ $ ____________________ $ ____________________ $ ____________________ 9 INDIVIDUAL REPORTING EXPENDITURES FOR ENTITY additional pages NO AMOUNT OF EXPENDITURES REPORTED FOR ENTITY YES NAME OF ENTITY ADDRESS OF ENTITY PHONE NO. OF ENTITY 10 SIGNATURE To the best of my knowledge the accompanying document is true and correct and includes all information to be reported by me under Chapter 305, Government Code. I further affirm that, to the best of my knowledge, I have complied with Section 305.028, Government Code (Prohibited Conflicts of Interest). AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said_________________________________________________ , this the _______________ day of_______________________ , 20______ , to certify which, witness my hand and seal of office. Signature of officer administering oath Forms provided by Texas Ethics Commission Print name of officer administering oath www.ethics.state.tx.us Title of officer administering oath Revised 12/01/2015 American LegalNet, Inc. www.FormsWorkFlow.com LOBBY ACTIVITIES REPORT SUBJECT MATTER Use the FORM LA INSTRUCTION GUIDE for assistance in filling out this form. Attach additional copies of this form as needed. 2 REGISTRANT NAME 1 PAGE # FORM LA A SCHEDULE 3 Filer ID 4 SUBJECT MATTER CATEGORIES If your lobby communications pertained to subject matters not marked on your original lobby registration or on a previous amendment, check the appropriate boxes. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 abortion aeronautics aging agriculture alcoholic beverage regulation alcoholism & drug abuse aliens amusements, games, sports animals arts & humanities business & commerce cemeteries charitable & nonprofit organizations city government civil remedies & liabilities coastal affairs & beaches common carriers communications & press consumer protection corporations & associations corrections county government courts crime criminal procedures day care disaster preparedness & relief economic & industrial development education 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 elections energy environment ethics family issues fees & other non-tax revenue financial institutions fire fighters & police gambling handicapped persons health & health care highways & roads historic preservation & museums hospitals housing human services insurance labor law enforcement lawyers libraries malpractice-health care providers mental health & cognition military & veterans mines & mineral resources minors nursing homes occupational regulation 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 oil & gas open records & open meetings parks & wildlife political subdivisions probate product liability property interests public lands purchasing redistricting religion retirement systems safety special districts & authorities state agencies, boards & commissions state employees, officers & symbols state finances taxation tort reform tourism transportation utilities vehicles & traffic water weapons women's issues OTHER _________________________ 5 DOCKET NOS. OR OTHER DESIGNATION not applicable additional pages DESIGNATION AGENCY DESIGNATION AGENCY DESIGNATION AGENCY GO TO SCHEDULE B Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 12/01/2015 American LegalNet, Inc. www.FormsWorkFlow.com DETAILED EXPENDITURES TRANSPORTATION & LODGING Use the FORM LA INSTRUCTION GUIDE for assistance in filling out this form. Attach additional copies of this form as needed. 2 REGISTRANT NAME 1 PAGE # FORM LA B SCHEDULE 3 Filer ID 4 RECIPIENT NAME LAST; SUFFIX; FIRST; TITLE 5 TRANSPORTATION INFORMATION TYPE OF TRANSPORTATION DEPARTURE CITY TRAVEL DATES Month DEPARTURE Day Year / Month Day / Year ARRIVAL CITY ARRIVAL / / 6 LODGING INFORMATION NAME OF LODGING ESTABLISHMENT ADDRESS; CITY; STATE; ZIP CODE LODGING DATES Month CHECK IN Month CHECK OUT Day Year / Day / Year / / 7 PREVIOUS REPORTING PERIOD Credit card expenditure occurred during the previous reporting period: 8 TRANSPORTATION / LODGING PURPOSE RECIPIENT NAME LAST; SUFFIX; FIRST; TITLE TRANSPORTATION INFORMATION TYPE OF TRANSPORTATION DEPARTURE CITY TRAVEL DATES Month DEPARTURE Day Year / Month Day / Year ARRIVAL CITY ARRIVAL / / LODGING INFORMATION NAME OF LODGING ESTABLISHMENT ADDRESS; CITY; STATE; ZIP CODE LODGING DATES Month CHECK IN Month CHECK OUT Day Year / Day / Year / / PREVIOUS REPORTING PERIOD TRANSPORTATION / LODGING PURPOSE Credit card expenditure occurred during the previous reporting period: GO TO SCHEDULE C Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 12/01/2015 American LegalNet, Inc. www.FormsWorkFlow.com DETAILED EXPENDITURES FOOD & BEVERAGES Use the FORM LA INSTRUCTION GUIDE for assistance in filling out this form. Attach additional copies of this form as needed. 2 REGISTRANT NAME 1 PAGE # FORM LA C SCHEDULE 3 Filer ID 4 RECIPIENT NAME LAST; SUFFIX; FIRST; TITLE 5 PLACE OF EXPENDITURE NAME OF RESTAURANT OR OTHER PLACE ADDRESS; CITY; S