LOBBYING REGISTRATION

Lobbying Disclosure Act of 1995 (Section 4)

REGISTRANT Organization/Lobbying Firm Self Employed Individual

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

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

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.

LOBBYING ISSUES

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

12. Specific lobbying issues (current and anticipated)

Marketplace Fairness Act

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?

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?

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