Clerk of the House of Representatives
Legislative Resource Center
135 Cannon Building
Washington, DC 20515
http://lobbyingdisclosure.house.gov 		Secretary of the Senate
Office of Public Records
232 Hart Building
Washington, DC 20510
http://www.senate.gov/lobby

LOBBYING REGISTRATION

Lobbying Disclosure Act of 1995 (Section 4)

Check One: New Registrant New Client for Existing Registrant Amendment

1. Effective Date of Registration
3/31/2017
2. House Identification
 43562
 Senate Identification
 401104373

REGISTRANT Organization/Lobbying Firm Self Employed Individual

3. Registrant Organization
YOUR AMERICAN FAMILY
Address
9108 Wellington Pl
 Address2
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City
Lanham
 State
MD
 Zip
20706-2073
 Country
USA

4. Principal place of business (if different than line 3)

City
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State
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Zip
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Country
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5. Contact name and telephone number International Number
Contact
​Mr. Donald R Green Jr
 Telephone
​2405736998
 E-mail
​d.green42192@gmail.com
6. General description of registrant’s business or activities
​A business offering supplemental insurance and online marketing.

CLIENT A Lobbying Firm is required to file a separate registration for each client. Organizations employing in-house lobbyists should check the box labeled “Self” and proceed to line 10. Self

7. Client name
​YOUR AMERICAN FAMILY
Address
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City
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State
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Zip
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Country
​USA
8. Principal place of business (if different than line 7)
City
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State
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Zip
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9. General description of client’s business or activities
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LOBBYISTS

10. Name of each individual who has acted or is expected to act as a lobbyist for the client identified on line 7. If any person listed in this section has served as a “covered executive branch official” or “covered legislative branch official” within twenty years of first acting as a lobbyist for the client, state the executive and/or legislative position(s) in which the person served.

Name Covered Official Position (if applicable)
First
Last
Suffix
​Donald ​Green ​ ​Proprietor
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LOBBYING ISSUES

11. General lobbying issue areas (Select all applicable codes).

​LAW
​DEF
​ACC
​ECN
​CIV
​EDU
​BAN
​TAX
​HOU

12. Specific lobbying issues (current and anticipated)

Social Security, Government Infrastructure, Race Relations.

AFFILIATED ORGANIZATIONS

13. Is there an entity other than the client that contributes more than $5,000 to the lobbying activities of the registrant in a quarterly period and either participates in and/or in whole or in major part supervises or controls the registrant’s lobbying activities?

No --> Go to line 14. Yes --> Complete the rest of this section for each entity matching the criteria above, then proceed to line 14.
Internet Address:
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Name Address Principal Place of Business
Street
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FOREIGN ENTITIES

14. Is there any foreign entity

a) holds at least 20% equitable ownership in the client or any organization identified on line 13; or

b) directly or indirectly, in whole or in major part, plans, supervises, controls, directs, finances or subsidizes activities of the client or any organization identified on line 13; or

c) is an affiliate of the client or any organization identified on line 13 and has a direct interest in the outcome of the lobbying activity?

No --> Sign and date the registration. Yes --> Complete the rest of this section for each entity matching the criteria above, then sign the registration.
Address Ownership
Name Street Principal place of business Amount of contribution
City State/Province Country
(city and state or country) for lobbying activities
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Signature
Digitally Signed By: Donald Green
 Date
4/3/2017 4:41:32 PM
ADDITIONAL LOBBYISTS

10. Supplemental. List any additional lobbyists for this client not listed on page 1, number 10.

Name Covered Official Position (if applicable) Have you been convicted of a crime?
First
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Suffix
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ADDITIONAL LOBBYING ISSUES
11. Supplemental. General lobbying issue areas. Enter any additional codes for issues not listed on page 2, number 11.
​RET
​ENG
​APP
​AGR
​ALC
​FAM
​DIS
​FOR
​ADV
ADDITIONAL AFFILIATED ORGANIZATIONS13. Supplemental. List any other affiliated organization that meets the criteria specified and is not listed on page 2, number 13.
Name Address Principal Place of Business
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ADDITIONAL FOREIGN ENTITIES
14. Supplemental. List any other foreign entity that meets the criteria specified and is not listed on page 2, number 14.
Name Address Principal place of business
(city and state or country) 		Amount of contribution for lobbying activities Ownership
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ADDITIONAL LOBBYISTS

10. Supplemental. List any additional lobbyists for this client not listed on page 1, number 10.

Name Covered Official Position (if applicable) Have you been convicted of a crime?
First
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ADDITIONAL LOBBYING ISSUES
11. Supplemental. General lobbying issue areas. Enter any additional codes for issues not listed on page 2, number 11.
​MMM
​NAT
​VET
​BUD
​CON
​URB
​COM
​GOV
​HCR
ADDITIONAL AFFILIATED ORGANIZATIONS13. Supplemental. List any other affiliated organization that meets the criteria specified and is not listed on page 2, number 13.
Name Address Principal Place of Business
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ADDITIONAL FOREIGN ENTITIES
14. Supplemental. List any other foreign entity that meets the criteria specified and is not listed on page 2, number 14.
Name Address Principal place of business
(city and state or country) 		Amount of contribution for lobbying activities Ownership
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ADDITIONAL LOBBYISTS

10. Supplemental. List any additional lobbyists for this client not listed on page 1, number 10.

Name Covered Official Position (if applicable) Have you been convicted of a crime?
First
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ADDITIONAL LOBBYING ISSUES
11. Supplemental. General lobbying issue areas. Enter any additional codes for issues not listed on page 2, number 11.
​INS
​DOC
​HOM
​MIA
​INT
​LBR
​SMB
​AER
​IMM
ADDITIONAL AFFILIATED ORGANIZATIONS13. Supplemental. List any other affiliated organization that meets the criteria specified and is not listed on page 2, number 13.
Name Address Principal Place of Business
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ADDITIONAL FOREIGN ENTITIES
14. Supplemental. List any other foreign entity that meets the criteria specified and is not listed on page 2, number 14.
Name Address Principal place of business
(city and state or country) 		Amount of contribution for lobbying activities Ownership
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ADDITIONAL LOBBYISTS

10. Supplemental. List any additional lobbyists for this client not listed on page 1, number 10.

Name Covered Official Position (if applicable) Have you been convicted of a crime?
First
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ADDITIONAL LOBBYING ISSUES
11. Supplemental. General lobbying issue areas. Enter any additional codes for issues not listed on page 2, number 11.
​FIN
​IND
​MON
​WEL
​WAS
​TRD
​SCI
​RES
​REL
ADDITIONAL AFFILIATED ORGANIZATIONS13. Supplemental. List any other affiliated organization that meets the criteria specified and is not listed on page 2, number 13.
Name Address Principal Place of Business
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ADDITIONAL FOREIGN ENTITIES
14. Supplemental. List any other foreign entity that meets the criteria specified and is not listed on page 2, number 14.
Name Address Principal place of business
(city and state or country) 		Amount of contribution for lobbying activities Ownership
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ADDITIONAL LOBBYISTS

10. Supplemental. List any additional lobbyists for this client not listed on page 1, number 10.

Name Covered Official Position (if applicable) Have you been convicted of a crime?
First
Last
Suffix
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ADDITIONAL LOBBYING ISSUES
11. Supplemental. General lobbying issue areas. Enter any additional codes for issues not listed on page 2, number 11.
​FIR
​CDT
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ADDITIONAL AFFILIATED ORGANIZATIONS13. Supplemental. List any other affiliated organization that meets the criteria specified and is not listed on page 2, number 13.
Name Address Principal Place of Business
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ADDITIONAL FOREIGN ENTITIES
14. Supplemental. List any other foreign entity that meets the criteria specified and is not listed on page 2, number 14.
Name Address Principal place of business
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