Form 635 Report of Lobbyist Employer and Report of Lobbying Coalition CALIFORNIA FORM 635 Lobbyist Employers: A person, other than a lobbying firm, who employs a lobbyist or contracts with a lobbying firm for economic consideration for the purpose of influencing legislative or administrative action is a "Lobbyist Employer." The Form 635 must be filed by lobbyist employers for each calendar quarter, regardless of whether the employer has made or incurred any payments during the quarter. In addition, a lobbyist employer must attach to the Form 635 the following: 1) A Form 615 (Lobbyist Report) completed by each in-house employee who is a lobbyist; and 2) An Attachment Form 640 (Other Payments to Influence Legislative or Administrative Action Report). Lobbying Coalitions: A group of 10 or more individuals or entities which pool their funds for the purpose of sharing the expenses of employing a lobbyist or contracting for the services of a lobbying firm is a "Lobbying Coalition." The Form 635 must be filed by lobbying coalitions for each calendar quarter, regardless of whether the coalition has made or incurred any payments during the quarter. Lobbying coalitions must attach to the Form 635 the following: 1) A Form 635-C (Payments Received By Lobbying Coalitions) disclosing payments received from members of the coalition; 2) A Form 615 (Lobbyist Report) completed by each in-house employee who is a lobbyist; and 3) An Attachment Form 640 (Other Payments to Influence Legislative or Administrative Action Report). An individual or entity that only makes payments to a lobbying coalition is not required to file this form, but may be required to file a Form 645 (Report of Person Spending $5,000 or More to Influence Legislative or Administrative Action). Where to File Electronic Filing: The Form 635 must be filed electronically with the Secretary of State if the total amount of any category of reportable payments, expenses, gifts, or other items is $2,500 or more in a calendar quarter. All subsequent quarterly reports must also be filed electronically. No paper copies are required. Paper Filing: If the Form 635 is not required to be electronically, an original and one copy of the Form 635 must be filed with: Secretary of State Political Reform Division 1500 11th Street, Room 495 Sacramento, CA 95814 When to File Deadline April 30 July 31 October 31 January 31 Period Covered January 1 ­ March 31 April 1 ­ June 30 July 1 ­ September 30 October 1 ­ December 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. For additional information about the Form 635 and other lobbying reports and requirements, see the Lobbying Disclosure Manual. Form 635 (Jul/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com REPORT OF LOBBYIST EMPLOYER or REPORT OF LOBBYING COALITION (2 Cal. Code of Regs. Section 18616.4) (Government Code Section 86116) CALIFORNIA FORM 635 OF PAGE IMPORTANT: Lobbying Coalitions must attach a completed Form 635-C to this Report. FOR OFFICIAL USE ONLY REPORT COVERS PERIOD FROM CUMULATIVE PERIOD BEGINNING THROUGH A TYPE OR PRINT IN INK NAME OF FILER: B BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: ( ) PART I - LEGISLATIVE OR STATE AGENCY ADMINISTRATIVE ACTIONS ACTIVELY LOBBIED DURING THE PERIOD (See instructions on reverse.) If more space is needed, check box and attach continuation sheets. SUMMARY OF PAYMENTS THIS PERIOD A. Total Payments to In-House Employee Lobbyists (Part III, Section A, Column 1) ............................................ $ B. Total Payments to Lobbying Firms (Part III, Section B, Column 4) ................................................................... $ C. Total Activity Expenses (Part III, Section C) ....................................................................................................... $ D. Total Other Payments to Influence (Part III, Section D) ...................................................................................... $ GRAND TOTAL (A + B + C + D above) ................................................................................................. $ E. Total Payments in Connection with PUC Activities (Part III, Section E) ............................................................. $ F. Campaign Contributions: Part IV completed and attached No campaign contributions made this period 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 Employer or Responsible Officer) Name of Employer or Responsible Officer (Type or Print) Title American LegalNet, Inc. www.FormsWorkFlow.com CALIFORNIA FORM INSTRUCTIONS FOR COMPLETING PAGE 1 635 Check the box to indicate whether you are filing a report as a "Lobbyist Employer" or a "Lobbying Coalition." NOTE: Lobbying Coalitions must also complete and attach Form 635-C. PERIOD COVERED BY REPORT: The period covered is the calendar quarter. (See the cover sheet of this form for periods covered.) CUMULATIVE PERIOD BEGINNING: The "cumulative period" begins with January 1 of the current 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 - LEGISLATIVE OR STATE AGENCY ADMINISTRATIVE ACTIONS ACTIVELY LOBBIED DURING THE PERIOD: You must report the legislative bills and state agency administrative actions which you "actively" influenced or attempted to influence, or your lobbyist or any lobbying firm with which you contract "actively" influenced or attempted to influence on your behalf during the calendar quarter. "Actively" lobbied means that a partner, owner, officer, or employee, or a lobbying firm with which you have contracted, either has