Free Updated lobact.p65 - Wyoming

LOBBYIST ACTIVITY REPORT W.S. 28-7-201
This form can be accessed on the Secretary of State's WEBSITE at: http://soswy.state.wy.us/Forms/FormsFiling.aspx

Wyoming Lobbyist rules state: "A lobbyist who has incurred lobbying expenses equal to or greater than $500.00 in total shall file a report. If the amount of reportable expenses is equal to or greater than $500.00, itemization of reportable expenses is required." Pursuant to W.S. 28-7-201 "joint reports by the lobbyist and organization may be made and the lobbyist may report on behalf of the organization." Lobbyist Activity Reports shall be filed annually no later than June 30 for activities during the preceding year - May 1 through April 30. W.S. 28-7-102 states: "Any person or organization failing to file a lobbyist activity report required under this section or who files a lobbyist activity report containing information which the lobbyist knows to be false is guilty of a misdemeanor punishable by a fine of not more than seven hundred fifty dollars ($750.00). Upon a second or subsequent conviction under this section, any person or organization shall have his right to be a registered lobbyist revoked by the Secretary of State for a period of up to two (2) years in addition to any fine."

FILING DEADLINES ..... FILING OFFICE .....

June 30th Wyoming Secretary of State State Capitol Building 200 W. 24th St. Cheyenne, WY 82002-0020

03/2009 - lobact

Report covers period from May 1st to April 30th Initial Report Lobbyist Name:________________________________________ Lobbyist Signature: ____________________________________ Total Lobbyist expenses were equal to or greater than $500.00. Yes (If no, a report is not required.) Check one : Amended Report

If reportable expenses are equal to or greater than $500.00, itemize below. Reportable expenses are defined in W.S.28-7-201(d) and (e).

Date of Expenditure

Lobbyist's Source of Funding

Item or Activity

Name of Recipient

Expense

__________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
TOTAL - PAGE 1 Page 1 $

II. Information required under W.S. 28-7-201(e) - Special Events/Functions

Date

Lobbyist's Source of Funding

Event or Function

Name of Group Invited

Expense

__________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
TOTAL - PAGE 2 $

GRAND TOTAL
Page 2

$