1990 FORM 625 REPORT OF LOBBYING FIRM The "Report of Lobbying Firm" (Form 625) must be completed by registered lobbying firms for each calendar quarter, regardless of the level of activity of the firm, and whether or not the firm has received or made any payments during the quarter. REMINDER: An individual contract lobbyist is a lobbying firm. The firm must attach to the Form 625 a "Lobbyist Report" (Form 615) completed by each partner, owner, officer, or employee of the firm who qualifies as a lobbyist unless that individual is separately registered as a lobbying firm. If the firm makes payments to a lobbying coalition (see the 1990 "Information Manual on Lobbying Disclosure Provisions" for definition), the firm also must attach a completed Form 630 (Payments Made to Lobbying Coalitions) to the quarterly report (Form 625). An original and one copy of the Form 625 must be filed with the Secretary of State. Secretary of State Political Reform Division 1500 11th Street P.O. Box 1467 Sacramento, CA 95812-1467 The periods covered and the filing deadlines for reports are as follows: PERIOD COVERED FILING DEADLINE January, February, and March April, May, and June July, August, and September October, November, and December April 30 July 31 October 31 January 31 If a report is sent by first class mail, it is considered received on the date of postmark. Filing deadlines which fall on a Saturday, Sunday, or official state holiday are extended to the next regular business day. IMPORTANT: Except as noted above, there are no provisions in the Political Reform Act for extension of the filing deadlines. A person who files after a deadline is liable for a fine of $10 per day until the report is filed. INSTRUCTIONS FOR COMPLETING THE REPORT ARE ON THE BACK OF EACH PAGE. REFER TO THE INFORMATION MANUAL ON LOBBYING DISCLOSURE PROVISIONS OF THE POLITICAL REFORM ACT FOR FURTHER INFORMATION. FOR ASSISTANCE, CALL 916/322-5660. American LegalNet, Inc. www.FormsWorkflow.com REPORT OF LOBBYING FIRM (Government Code Section 86114) REPORT COVERS PERIOD FROM THROUGH FORM 625 1990 CUMULATIVE PERIOD BEGINNING FOR OFFICIAL USE ONLY A B TYPE OR PRINT IN INK For information required to be provided to you pursuant to the Information Practices Act of 1977, see Information Manual on Lobbying Disclosure Provisions of the Political Reform Act. NAME OF LOBBYING FIRM: BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: ( ) MAILING ADDRESS: (If different than above) PART I - (Read the instructions on the reverse before completing this section. Then, check one of the boxes below and complete Part I.) PARTNERS, OWNERS, OFFICERS, OR EMPLOYEES WHOSE "LOBBYIST REPORTS" (FORM 615) ARE ATTACHED TO THIS REPORT OR PARTNERS, OWNERS, OFFICERS, OR EMPLOYEES WHO ENGAGED IN DIRECT COMMUNICATION ON AT LEAST FIVE SEPARATE OCCASIONS DURING THE PERIOD If more space is needed, check box and attach continuation sheets. SUMMARY OF PAYMENTS THIS PERIOD A. GRAND TOTAL PAYMENTS RECEIVED: $ (From Subtotals in Part II) TOTAL ACTIVITY EXPENSES: (From Part III, Section A, 3) TOTAL PAYMENTS TO OTHER LOBBYING FIRMS: (From Part III, Section B) GRAND TOTAL PAYMENTS MADE: (B + C, above) $ $ E. CAMPAIGN CONTRIBUTIONS MADE: None This Period Part IV Completed and Attached B. C. F. IS THE FIRM A MEMBER OF A LOBBYING COALITION? No Yes (Complete and attach Form 630) D. $ VERIFICATION I have used all reasonable diligence in preparing this Report. I have reviewed the Report and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on (Date) At (City and State) By (Signature of Responsible Officer) Name of Responsible Officer (Type or Print) Title American LegalNet, Inc. www.FormsWorkflow.com FORM 625 INSTRUCTIONS FOR COMPLETING PAGE 1 PERIOD COVERED BY REPORT: The period covered is the calendar quarter. (See the cover sheet of this form for period covered.) CUMULATIVE PERIOD BEGINNING: The "cumulative period" begins with January 1 of the biennial legislative session; except for the first report a filer is required to file, in which case the cumulative period begins with the first day of the calendar quarter in which the filer qualified. PART I -- PARTNERS, OWNERS, OFFICERS, AND EMPLOYEES WHOSE "LOBBYIST REPORTS" (FORM 615) ARE ATTACHED TO THIS REPORT, OR WHO ENGAGED IN DIRECT COMMUNICATION DURING THE PERIOD: · If an owner, partner, or employee of the lobbying firm qualifies as a "lobbyist," you must attach a "Lobbyist Report" (Form 615) completed by that individual, and you must list that individual's name in Part I of the report. NOTE: This does not include lobbyists who are registered separately as lobbying firms or who are employed by lobbying firms with which you subcontract. If no owner, partner, or employee of the lobbying firm qualifies as a "lobbyist," you must provide the name and title of each partner, owner, officer, or employee of the lobbying firm who, on at least five separate occasions during the reporting period, engaged in direct communication with any elective state official, legislative official, or agency official for the purpose of influencing legislative or administrative action. This does not include employees whose actions were purely clerical. "Direct communication" means appearing as a witness before, talking to (either by telephone or in person), corresponding with, or answering questions or inquiries from a qualifying official either personally or through an agent who acts under one's direct supervision, control, or direction. · SUMMARY OF PAYMENTS: Enter the total amounts received and paid this period from each section of the report. CAMPAIGN CONTRIBUTIONS: Check the box to indicate whether the firm or a committee sponsored by the firm has made reportable campaign contributions. MEMBERS OF LOBBYING COALITIONS: Check the box to indicate whether the firm is a member of a lobbying coalition. (See the Information Manual on Lobbying Disclosure Provisions of the Political Reform Act for definitions.) If the firm is a member of a lobbying coalition, complete and attach Form 630. VERIFICATION: The report must be verified and signed by the person who is designated on the firm's registration statement as the responsible officer of the firm. REFER TO THE INFORMATION MANUAL ON LOBBYING DISCLOSURE PROVISIONS OF THE POLITICAL REFOR