Lobbyist Contact Disclosure

Lobbyist Contact Disclosure
Meeting Date and Time*

MonthDayYear
Date
Hour MinutesAM/PM Option
Lobbyist Name*
Lobbying On Behalf Of*
Name Of The Entity By Which Lobbyist Is Employed*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Add your best contact to reach you.
E-mail Address*
example@example.com
Meeting Details
Names of People in Attendance or Participating in the Lobbying Communication*
Commission Member Meeting With*

Mayor Scott BrookVice Mayor Nancy Metayer BowenCommissioner Shawn CerraCommissioner Joshua SimmonsCommissioner Joe McHugh
Mode Of Communication*

In PersonBy PhoneEmailOther
Purpose And Subject Matter For Meeting*
By typing my name in the below space, I am electronically signing this form. My signing this electronic signature certifies the information to be true, accurate, and complete.*

First NameLast Name
Should be Empty:

Meeting Details