Fillable Printable Form 635
Fillable Printable Form 635
Form 635
1993
FORM
635
REPORT
OF
LOBBYIST EMPLOYER
AND
REPORT
OF
LOBBYING COALITION
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 its quarterly report a "Lobbyist Report" (Form 615) completed by each in-
house employee who
is
a lobbyist. NOTE: State
and
local governmental agencies which
are
lobbyist
employers must also complete Attachment 640.
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
also must attach to the Form 635 the following:
1)
A Form 635-C (Payments Received By Lobbying
Coalitions) disclosing payments received from members
ofthe
coalition; and 2) A Form 615 (Lobbyist Report)
completed by each in-house employee who is a lobbyist. NOTE:
State
and
local governmental agencies
which
are
lobbying coalitions must also complete Attachment 640.
An individual or entity which only makes payments to a lobbying coalition is not required to file this Form.
However, an individual or entity which makes payments to a lobbying coalition may be required to file reports
as
a "Person Who Spends $5,000 or More to Influence Legislative or Administrative Action" (Form 645).
An original and one copy
of
the Form 635 must be filed with the Secretary
of
State.
Secretary
of
State
Political Reform Division
1500
11
th 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
30
April, May, and June
July
31
July, August, and September
October
31
October, November, and December
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.
D REPORT
OF
LOBBYIST EMPLOYER
(Government Code Section 86116)
PAGE
__
_
OF
__
_
or
D REPORT
OF
LOBBYING COALITION
(2 Cal. Code
of
Regs. Section 18616.4)
FORM 635
IMPORTANT: Lobbying Coalitions must attach a
1993
completed Form 635-C to this Report.
REPORT COVERS PERIOD FROM
-------
THROUGH
FOR
OFFICIAL
USE
ONLY
CUMULATIVE PERIOD BEGINNING
_____________
_
A
TYPE
OR
PRINT
IN
INK
For information required to be provided to you pursuant to the Information Practices Act
of
1977. see Information B
Manual on
Lobbyin~
Disclosure Provisions Qfthe Political Reform Act.
NAME
OF
FILER:
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 instuctions on reverse.)
D 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 I) ............................................ $
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 + 0 above) ................................................................................................. $
E.
Total Payments in Connection with PUC Activities (Part III, Section E) ........................................................... $
F.
Campaign Contributions: D Part
IV
completed and attached
D
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 informa-
tion 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
FORM
635
INSTRUCTIONS FOR COMPLETING PAGE 1
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 engaged
in
direct
communication, or has been directed by you to engage
in
direct communication, with a qualifying
official for the purpose
of
influencing legislative or administrative action during the reporting
period. (See the Information Manual on Lobbying Disclosure Provisions
of
the Political Reform Act
for the definition
of
"direct communication.") Do not list bills or administrative actions which have
died prior to the reporting period, or those which are only being watched or monitored, or those
which you have not attempted to influence during the reporting period. You may either list the
legislative bill numbers and administrative regulation numbers or provide a brief description
of
each
legislative or administrative action actively lobbied during the quarter. When listing state
administrative actions, provide the name
of
the state agency or department.
SUMMARY OF PAYMENTS: Enter the total amounts paid this period from each section
of
the
report. With respect to campaign contributions, check the box which applies to your activities
during the calendar quarter.
VERIFICATION: The report must be verified and signed by the filer.
In
the case
of
an organization,
a responsible officer
of
the organization, or an attorney or a certified public accountant must sign on
behalf
of
the organization.
REFER TO THE INFORMATION MANUAL
ON
LOBBYING DISCLOSURE PROVISIONS
OF
THE
POLITICAL REFORM
ACT
FOR FURTHER INFORMATION. FOR ASSISTANCE,
CAU
916/322-5660.
PAGE
___
OF
__
_
NAME
OF
FILER:
______________________
_
PERIOD COVERED:
________
_
PART
II·
PARTNERS,
OWNERS,
AND
EMPLOYEES
WHOSE
"LOBBYIST
REPORTS"
(FORM
615)
ARE
ATTACHED
TO
THIS
REPORT
(See instructions on reverse.)
Name and Title
Name and Title
D If
more
space
is
needed.
check
box
and
attach continuation sheets.
PART
III·
PAYMENTS
MADE
IN
CONNECTION
WITH
LOBBYING
ACTIVITIES
(1)
(2)
A.
PAYMENTS
TO
IN·HOUSE EMPLOYEE LOBBYISTS
Cumulative Total
Amount This
(See
instructions
on
reverse.
Also
enter
the
Amount
This
Period
To
Date
Period
(Column
I)
on
Line A of
the
Summary of Payments section
on
page
I.)
$
$
B.
PAYMENTS TO LOBBYING
FIRMS
(Including
Individual
Contract Lobbyists)
(1)
(2)
(3)
(4)
(5)
Name and Address
of
Lobbying
Advances or
Fees
& Reimbursements Total Cumulative
Firm/Independent Contractor
Other Payments
Retainers
of
Expenses
This Period
Total to Date
(attach explanation)
TOTAL
THIS PERIOD (Column 4)
D
If
more
space
is
needed. check
box
and
attach
Also enter the total
of
Column 4 on Line B
of
the $
continuation sheets.
Summary
of
Payments section on page
I.
FORM
635
INSTRUCTIONS FOR COMPLETING PAGE 2
PART
II
--
PARTNERS, OWNERS, OFFICERS, AND EMPLOYEES WHOSE "LOBBYIST
REPORTS"
(FORM 615) ARE ATTACHED
TO
THIS REPORT: You must attach a "Lobbyist Report" (Form 615)
completed by each owner, partner, officer,
or
employee who qualifies as a "lobbyist," and you must list
that individual's name in Part II
of
the Report. NOTE:
Th.is
does not include lobbyists who are registered
separately as lobbying firms or lobbyists who are employed by lobbying firms with which you contract.
PART
III
--
PAYMENTS MADE IN CONNECTION
WITH
LOBBYING ACTIVITIES
SECTION
A.
Payments to In-House Lobbyists: You must enter the total
of
all payments made in
connection with lobbying activities during the quarter to the lobbyists listed in Part II
of
the Report. You
must also report the cumulative amount
of
payments to in-house lobbyists since January 1
of
the biennial
legislative session for which the report is being filed. "Payments" include salary, reimbursement
of
expenses, an advance for expenses or a salary advance
or
any other payments made in connection with
lobbying activities. (Salary includes gross wages paid, plus any fringe benefits which are in lieu
of
wages
such as the granting
of
stock options
or
purchase
of
annuities. Salary does not include routine fringe
benefits such as the employer's contributions to a health plan, retirement plan,
or
payroll taxes.) Also
enter the total
of
Section A in the "Summary
of
Payments': section on Page
1,
Line
A.
NOTE: An
individual contract lobbyist is a "lobbying firm."
Do
not include in Section A any payments to lobbying
firms.
SECTION B. Payments to Lobbying Firms (Including Individual Contract Lobbyists): A "lobbying firm"
is any business entity, including an individual contract lobbyist, which contracts for economic
consideration for the purpose
of
influencing legislative or administrative action on behalf
of
another
person. You must disclose all payments to a lobbying firm, including fees and retainers, reimbursement
of
expenses, advances,
or
other payments. You must also report the cumulative amount
of
payments to
the lobbying firm since January 1
of
the biennial legislative session for which the report is being filed.
Also enter the total
of
Column 4 in the "Summary
of
Payments" section on Page
1,
Line B.
IMPORTANT: You must list each lobbying firm which has been authorized to lobby on your
behalf, even
if
you have not made any payments to the firm during the period covered by this
report.
If
no payments have been made during the quarter, enter the name
of
the lobbying firm in
the proper section, and enter zeros in the columns.
If
you have made any payments to the lobbying
firm since January 1
of
the biennial legislative session, you must enter the "cumulative total to
date" in Column 5.
REFER TO THE INFORMATION MANUAL
ON
LOBBYING DISCLOSURE PROVISIONS
OF
THE
POL/TICAL REFORM
ACT
FOR FURTHER INFORMATION. FOR ASSISTANCE,
CAU
916/322-5660.
PAGE
___
OF
NAMEOFALER:
_________________________________________
__
PERIOD COVERED:
______________
_
C.
ACTIVITY
EXPENSES
(See instructions on reverse.)
Name and Official Position
Description
of
Total
Date
Name and Address
of
Payee
of
Reportable Persons and
Consideration
Amount
Amount Benefiting Each
of
Activity
$
$
o
If
more space is needed. check box and attach
TOTAL SECTION C (Activity Expenses)
$
continuation sheets.
Also enter the total
of
Section C on Line C
of
the Summary
of
Payments section on page I.
D.
o
OTHER
PAYMENTS
TO
INFLUENCE
LEGISLATIVE
OR
ADMINISTRATIVE
ACTION
NOTE: State and local government agencies do not complete this section. Check box and complete
Attachment Form 640 instead.
$_----
I.
PAYMENTS TO LOBBYING COALITIONS (NOTE: You must attach a completed
Form 630 to this Report.)
$------
2.
OTHER PAYMENTS
TOTAL SECTION
D
(I
+ 2) Also $
enter the total
of
Section D on Line
D
of
the Summary
of
Payments
section on
I.
E. PAYMENTS
IN
CONNECTION
WITH
ADMINISTRATIVE
TESTIMONY
IN
RATEMAKING PROCEEDINGS
$
BEFORE
THE
CAUFORNIA
PUBLIC
UTIUTIES
COMMISSION Also. enter the total
of
Section E on Line E
of
the
Summary
of
Payments section on page I. (See instructions
on
reverse.)
FORM
635
INSTRUCTIONS
FOR
COMPLETING PAGE 3
SECTION
C.
Activity Expenses: An "activity expense" is any expense which benefits, in whole or in part,
an
elected state officer, a legislative official, an agency official, a state candidate, or a member
of
the immediate
family
of
such officials or candidates. Activity expenses include gifts, honoraria, consulting fees, salaries, and
any other form
of
compensation, but do not include campaign contributions.
You must itemize all activity expenses incurred by you, and you must report them during the period in which they
occurred, regardless
of
whether or not they were actually paid during the period, and the information outlined
below. This does not include activity expenses which were paid or incurred by a lobbyist and which were merely
reimbursed by you or charged to an account paid by you. However,
if
a lobbyist "arranges" any payment
incurred by a lobbyist employer which benefits a reportable person, both the employer and the lobbyist must
itemize the expense.
Date: Enter the date the expense was incurred or the event occurred.
Name
and
Address
of
Payee: List the name and address
of
the vendor or other person to whom payment was
made or incurred.
If
charged on a credit card, you must list the name
of
the credit card company and also the
name
of
the vendor which received the payment.
Name
and
Official Position
of
Reportable Persons and Amount Benefiting Each: List the name and official
position
if
any,
of
each reportable person who benefited from the payment. Also list the portion
of
the total
activity expense which is attributable to each reportable person. Note: You are not required to list in this
section yourself
or
any other person who benefited who is not a reportable person. You must, however,
maintain in your records the total number
of
persons who benefited.
Description
of
Consideration: Describe the goods or services received by the reportable person(s), e.g.,
lunch, drinks, flowers, etc.
Total Amount
of
Activity: Enter the total amount paid, arranged, or incurred for the activity, not just the
amount which benefited reportable persons. Regardless
of
the number of beneficiaries listed for a single
payment, enter the payment in the "Total Amount
of
Activity" column only once.
SECTION
D.
Other Payments to Influence Legislative or Administrative Action: (Governmental agencies
must
use
Form
640 to complete this section.)
Report as a lump sum all other payments you made in connection with your attempts to influence legislative or
administrative action. Such payments would include payments to a lobbying coalition; payments in support
of
your lobbyist (but not made directly to the lobbyist), such as the payment
of
a credit card charge for activity
expenses which have been reported by the lobbyist; payments for office overhead and operating expenses and
subscription services, payments to expert witnesses, and compensation paid to employees (other than a lobbyist)
who spend
10 percent or more
of
their compensated time in a calendar month in connection with lobbying
activities. Also enter the total
of
Section D in the "Summary
of
Payments" section on Page
1,
Line D. NOTE:
If
you
make
payments to a lobbying coalition, you
must
also
attach
a completed
Form
630
to
this
report.
SECTION E. Payments in Connection with Administrative Testimony in Ratemaking PI .eeedings Before the
California Public Utilities Commission: Filers who make payments in connection with administrative testimony
in ratemaking proceedings before the PUC (other than payments to a lobbyist or a lobbying firm) must report the
lump sum
of
these payments in Section E. Payments to be reported include compensation paid to all attorneys,
other than a lobbyist or a lobbying firm, for time spent testifying in the proceedings and compensation paid to
all witnesses, other than a lobbyist or a lobbying firm, for time spent testifying in the proceedings. Compensation
includes gross wages paid plus any benefits which are in lieu
of
wages such as the granting
of
stock options or
the purchase
of
annuities.
It
does not include routine fringe benefits such as the employer's contributions to a
health plan, retirement plan, or payroll taxes. No other in-house expenses or overhead in connection with such
proceedings are reportable. However,
if
you make payments to a lobbyist or a lobbying firm in connection with
PUC ratemaking proceedings, you must report the payments in Part III, Section A or B, whichever is applicable.
Also enter the total
of
Section E in the "Summary
of
Payments" section on Page
1,
Line E.
REFER TO
THE
INFORMATION MANUAL
ON
LOBBYING DISCLOSURE PROVISIONS
OF
THE
POLITICAL
REFORM
ACT
FOR FURTHER INFORMATION. FOR ASSISTANCE. CALL 916/322-5660.
PAGE
___
OF
__
_
NAME
OF
ALER:
_____________________
_
PERIOD
COVERED:
_______
_
PART
IV
--
CAMPAIGN
CONTRIBUTIONS
MADE
(Monetary and non-monetary campaign contributions
of
$100 or more
made to or on behalf
of
state candidates, elected state officers and any
of
their controlled committees, or committees supporting such
candidates or officers must be reported in A or B below.)
A.
If
the contributions made by you during the period covered by this report, or by a committee you sponsor, are contained
in a campaign disclosure statement which is on file with the Secretary
of
State, report the name
of
the committee and its
identification number,
if
any, below.
Name
of
Major Donor or Recipient Committee Which
Identification Number
if
Has Filed A Campaign Disclosure Statement:
Recipient Committee:
B.
Contributions
of
$100 or more which have not been reported on a campaign disclosure statement, including contributions
made by an organization's sponsored committee, must be itemized below.
Date
Name
of Recipient
LD.
Number
if
Amount
Committee
$
D
If
more
space
is
needed.
check
box
and
attach
continuation
sheets.
NOTE: Disclosure in this report does not relieve a filer of any obligation to file the campaign
disclosure statements required by Gov. Code Section 84200, et seq.
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