Free Updated lobbyist amendment form.p65 - Wyoming

AMENDED Lobbyist Registration Form
This form can be accessed on the Secretary of State's website at: http://soswy.state.wy.us/Forms/FormsFiling.aspx

Full name of lobbyist ____________________________________________________________ Please check the section of the form that you are amending: Name of Lobbyist Organization(s): Lobbyist's E-mail Address Lobbyist's Business/Home Address

Add (Provide name of organization, business address, phone, fax number) Delete (Provide name of organization to remove) Change (Indicate name of organization and provide corrected information)

New name of Lobbyist: _______________________________________________________ New Business/Home Address of Lobbyist: _________________________________________
_____________________________________________ _____________________________________________ Phone (___) ___________ Fax (___) ___________

_________________________________________________________________________

New E-mail of Lobbyist: ____________________________________________________ Organization(s): Add _______________________________________________________
Phone (___) ___________ Fax (___) ___________

_____________________________________

_______________________________________________

Delete

____________________________________

Phone (___) ___________ Fax (___) ___________

_______________________________________________ Change ____________________________________ _______________________________________________ _______________________________________________ Signature
lobbyist amendment form

Phone (___) ___________ Fax (___) ___________

______________________ Date

Organization(s): Add

_______________________________________________________
Phone (___) ___________ Fax (___) ___________

_____________________________________

_______________________________________________

Delete

____________________________________

Phone (___) ___________ Fax (___) ___________

_______________________________________________ Change ____________________________________ _______________________________________________

Phone (___) ___________ Fax (___) ___________

Organization(s): Add

_______________________________________________________
Phone (___) ___________ Fax (___) ___________

_____________________________________

_______________________________________________

Delete

____________________________________

Phone (___) ___________ Fax (___) ___________

_______________________________________________ Change ____________________________________ _______________________________________________ Organization(s): Add

Phone (___) ___________ Fax (___) ___________

_______________________________________________________
Phone (___) ___________ Fax (___) ___________

_____________________________________

_______________________________________________

Delete

____________________________________

Phone (___) ___________ Fax (___) ___________

_______________________________________________ Change ____________________________________ _______________________________________________

Phone (___) ___________ Fax (___) ___________