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Lobbying-Application To Obtain Logon ID Number And Password To File Online Or Electronically - California
| Lobbying-Application To Obtain Logon ID Number And Password To File Online Or Electronically Form. This is a California form and can be used in Political Reform Division Secretary Of State . |
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LOBBYING - APPLICATION TO OBTAIN LOGON ID NUMBER AND PASSWORD TO FILE ONLINE OR ELECTRONICALLY 1. I am submitting this application as a: (check one) Responsible Officer of Lobbyist Employer Responsible Officer of Lobbying Firm Lobbyist Other (specify)_____________________________________________________________________ 2. The name of the filing entity or person for which an ID number and a password are requested is: (type or print legibly) ___________________________________________________________________ ______________ (full name) (ID# if known) ____________________________________________________________________________________ (street address) (city) (state) (zip code) 3. The filer for which an ID number and a password are requested is a: (check one) Lobbying Firm Lobbyist Employer/Coalition Lobbyist Payment to Influence Filer Client of Lobbying Firm Other (specify)_____________________________________________________________________ 4. If you want to authorize an approved vendor to obtain your ID number and password for you, complete the following: I intend for an approved vendor or service provider to submit my lobbyist activity documents electronically on my behalf. I hereby authorize: __________________________________________________________________________________________ (insert full name of approved vendor/provider) to obtain my logon filing ID number and password in order to file my documents electronically. 5. If you are requesting an ID number and a password for a new client of a lobbying firm, indicate the name of the lobbying firm: __________________________________________________________________________________________ (insert full name of lobbying firm) Be sure to immediately amend your lobbying registration on paper with this office to reflect the new addition. It is the submitted paperwork, rather than the online/electronic filings, that will update your online record with the Office of the Secretary of State. 6. If you are requesting an ID number and a password for a new lobbyist of a firm or lobbyist employer, indicate the name of the lobbying firm or lobbyist employer: __________________________________________________________________________________________ (insert full name of lobbying firm or lobbyist employer) Be sure to immediately amend your lobbying registration on paper with this office to reflect the new addition. It is the submitted paperwork, rather than the online/electronic filings, that will update your online record with the Office of the Secretary of State. 7. I am entitled to file lobbying activity documents on behalf of the above entity or person. Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com 8. I hereby apply for the issuance of a logon ID number and a password in order to file lobbying activity documents online/electronically. 9. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on __________________________________at________________________________________________. (date) (where signed) X___________________________________________ (signature) ____________________ (phone number) __________________* (fax number) _________________________________________________ (printed name of signer) _________________________________________________ (e-mail address if available) *Be sure to include your fax number so that the ID number and the password can be returned to you. NOTE: Any online or electronic filing, by an approved vendor or otherwise, is presumed to be filed under penalty of perjury. (Government Code section 84605(h)) FAX THIS APPLICATION TO (916) 653-5045 (BOTH PAGES MUST BE FAXED BEFORE THE APPLICATION CAN BE PROCESSED.) (If you have questions, call the Help Line at 916-653-7283 or 877-745-3453.) Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com
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