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
10/15/2013
2. House Identification
 
Senate Identification
 401103165

REGISTRANT Organization/Lobbying Firm Self Employed Individual

3. Registrant Organization
The Afflerbach Group, LLC
Address
PO Box 0352
Address2
City
Red Lion
State
PA
Zip
17356-0352
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. Roy Afflerbach
Telephone
​7176085593
E-mail
​roy@theafflerbachgroup.com
6. General description of registrant’s business or activities
​Consulting and advocacy training

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
​National Adult Day Services Association (NADSA)
Address
​1421 E. Broad Street, Suite 425
City
​Fuquay Varina
State
​NC
Zip
​27526
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
​Professional association representing adult day servcies providers

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
​Roy ​Afflerbach
​Henry ​Annoni

LOBBYING ISSUES

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

​HCR
​MMM
​BUD

12. Specific lobbying issues (current and anticipated)

Adequate support for aging and disability long-term care; Adequate funding for Medicare and Medicaid; Managed Care Long-Term Supports and Services.


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
%

Signature
Digitally Signed By: Roy C Afflerbach, President The Afflerbach Group, LLC
Date
11/28/2013