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
10/1/2022
2. House Identification
 42337
Senate Identification
 401074020

REGISTRANT Organization/Lobbying Firm Self Employed Individual

3. Registrant Organization
The Jerry Costello Group, LLC
Address
138 Lincoln Place Court
Address2
​Suite 101
City
Belleville
State
IL
Zip
62221
Country
USA

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

City
State
Zip
Country
5. Contact name and telephone number International Number
Contact
​Mr. Jerry Costello
Telephone
​6182346701
E-mail
​thejerrycostellogroup@gmail.com
6. General description of registrant’s business or activities
​Government Consulting & Relations Firm

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
​Memorial Health
Address
​340 W. Miller Street
City
​Springfield
State
​IL
Zip
​62702
Country
​USA
8. Principal place of business (if different than line 7)
City
State
Zip
Country
9. General description of client’s business or activities
​Healthcare organization

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
​Jerry ​Costello ​Former Member of U.S. House of Representatives

LOBBYING ISSUES

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

​HCR

12. Specific lobbying issues (current and anticipated)

Health care policy issues


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:
Name Address Principal Place of Business
Street
City State/Province Zip Code Country
City
State
Country
City
State
Country
City
State
Country

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

City
State
Country
%
City
State
Country
%

CONVICTIONS DISCLOSURE

15. Have any of the lobbyists listed on this report been convicted in a Federal or State Court of an offense involving bribery, extortion, embezzlement, an illegal kickback, tax evasion, fraud, a conflict of interest, making a false statement, perjury, or money laundering?


Signature
Digitally Signed By: Jerry Costello
Date
11/10/2022 2:44:38 PM