HomeMy WebLinkAboutLobbyist Registration and Report of Expenditures Forms
INSTRUCTIONS FOR LOBBYIST REGISTRATION FORM
The following instructions are designed to assist you, as a lobbyist, in completing the
lobbyist registration form. For further reference, please review Chapter 2, Article 15, Section 2-
91.3 of the Hawai‘i County Code in its entirety. Further inquiries regarding this section should
be directed to the County Board of Ethics.
Definition of Lobbyist
: “Lobbyist” means any individual engaged for pay or other consideration
who spends more than five hours in any month or $275 in any six-month period for the purpose
of attempting to influence legislative or administrative action by communicating or urging others
to communicate with public officials.
Who Must File
: A lobbyist must register with the Hawai‘i County Clerk within five days of
becoming a lobbyist. A separate registration is required for each organization you represent.
Required Information
: Each lobbyist shall provide and certify the following information:
(A) The name, mailing address, and business telephone number of the lobbyist.
(B) The name and principal place of business of each person by whom the lobbyist is
retained or employed or on whose behalf the lobbyist appears or works and a
written authorization to act as a lobbyist from each person by whom the lobbyist
is employed or with whom the lobbyist contracts.
(C) The subject area on which the lobbyist expects to lobby.
Change in Status or Termination
:
(A) A lobbyist shall report any change in any of the information contained in the
registration statement within ten days after the change has occurred.
(B) A lobbyist shall file a notice of termination within ten days after the lobbyist
ceases the activity which required the lobbyist’s registration.The lobbyist and the
employer of the lobbyist shall remain subject, however, to the requirements of the
Hawai‘i County Code for the period during which the registration was effective.
Exceptions
: This section shall not apply to:
(A) Any individual who represents him or herself and not any other person before the
council or administrative agency;
(B) Any Federal, State, or County official or employee acting in the official or
employee’s official capacity;
(C) Any elected public official acting in the official or employee’s official capacity;
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(D) Any newspaper or other regularly published periodical or radio or television
station (including any individual who owns, publishes, or is employed by a
newspaper or periodical or radio or television station) while publishing in the
regular course of business news items, editorials, or other comments, or paid
advertisements, which directly or indirectly urge the passage or defeat of
legislative or administrative action; and
(E) Any person who possesses special skills and knowledge relevant to certain areas
of legislation, whose skills and knowledge may be helpful to the legislative and
executive branches of County government, and who is appearing at the request of
the council or an administrative agency, even though receiving reimbursement for
the appearance.
Filing Requirements
: Each lobbyist shall file a statement of expenditures with the County Clerk
on July 31 and January 31 of each year. If the date falls on a Saturday, Sunday or holiday, the
report is due on the next business day. The July 31 report shall cover the period from January 1
through June 30 of the year of the report; and the January 31 report shall cover the period from
July 1 through December 31 of the calendar year preceding the January 31 report.
Statements of Expenditures shall contain the following information:
(A) The name and address of each person with respect to whom expenditures for the
purpose of lobbying in the total sum of $25 or more per day were made by the
person filing the statement during the statement period and the amount or value of
such expenditure;
(B) The name and address of each person with respect to whom expenditures for the
purpose of lobbying in the aggregate of $150 or more were made by the person
filing the statement during the statement period and the amount or value of such
expenditures;
(C) The total sum or value of all expenditures for the purpose of lobbying made by
the person filing the statement during the statement period in excess of $275
during the statement period;
(D) The name and address of each person making contributions to the person filing
the statement for the purpose of lobbying in the total sum of $25 or more during
the statement period and the amount or value of such contributions; and
(E) The subject area of the legislative and administrative action which was supported
or opposed by the person filing the statement during the statement period.
The receipt or expenditure of any money for the purpose of influencing the election or defeat of
any candidate for an elective office or for the passage or defeat of any proposed measure at any
special or general election is excluded from the reporting requirement of County Code section
2-91.3.
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Advisory Opinions
: The Board of Ethics is empowered to render advisory opinions with respect
to the application of this section to any person. No person who conforms their conduct to an
advisory opinion of the board regarding this section shall be subject to the penalties provided
herein.
Penalties
: Any person who willfully fails to file any statement or report required by this section
or who willfully files a statement or report containing false information or material omission of
any fact, who engages in activities prohibited by this section, or who fails to provide any
information required by this section shall be guilty of a petty misdemeanor.
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OFFICE OF
THE COUNTY CLERK
25 Aupuni Street, Room 209
Hilo, Hawai‘i 96720
Telephone: (808) 961-8255
LOBBYIST REGISTRATION FORM
You must file this form with the Office of the County Clerk if you are an individual who is engaged for pay or other
consideration and spends more than five hours lobbying in any month or more than $275 in any six month period.
(Type or Print Clearly)
NAME Last First Middle
MAILING ADDRESS Street City State Zip Code
TELEPHONE NUMBER NAME OF PERSON OR ORGANIZATION YOU LOBBY FOR (DO NOT ABBREVIATE)
MAILING ADDRESS Street City State Zip Code
EMPLOYEE ORGANIZATION
MAILING ADDRESS Street City State Zip Code
DESCRIPTION OF SUBJECTS UPON WHICH YOU EXPECT TO LOBBY
Economic Development: Government-wide support: Employment:
Other: (Please indicate
government financing, taxation, work opportunity, working below)
commerce and industry, trade
and finance, tourism, revenue, appropriation, personnel conditions, compensation,
agricultureservices, employee funds unemployment and disability
compensation, vocational
rehabilitation
Public safety:
Transportation:
law enforcement and corrections,
Environmental protection:
air, water, and land transportation
safety from physical disasters
pollution control,
facilities and services
environmental preservation and
enhancement
Individual rights: Social Problems:
consumer protection, business and Social services, public assistance,
of housing
Culture and recreation: professional regulation
cultural history and events, services, legal assistance
recreational activities
CERTIFICATION OF LOBBYIST
I hereby certify that the information furnished above is, to the best of my knowledge, correct and complete.
________________________________________________ ___________________________________
(Signature of Lobbyist) (Date)
AUTHORIZATION TO LOBBY
NAME TITLE OF AUTHORIZING OFFICER OR PERSON REPRESENTED
NAME OF ORGANIZATION (if applicable)
ADDRESS OF ORGANIZATION OR PERSON Street City State Zip Code
I hereby authorize the above-named person to engage in lobbying activities on behalf of the undersigned
.
(Signature of Authorizing Officer of Person Represented) (Date)
05/09
OFFICE OF
THE COUNTY CLERK
25 Aupuni Street, Room 209
Hilo, Hawai‘i 96720
Telephone: (808) 961-8255
LOBBYIST REPORT OF EXPENDITURES,
CONTRIBUTIONS, AND SUBJECT AREAS
(Type or print clearly – no carbon required)
For lobbying reporting period: Lobbyist: Phone:
January 1 – June 30 Employer
July 1 – December 31 Mailing Address
Year of Report 20 .
PART I. TOTAL EXPENDITURES
The total sum or value of all expenditures for the purpose of lobbying during the statement period was: $0$275 or less Over $275.
The total number of hours spent for the purpose of lobbying during the statement period was: 05 hours or less More than 5 hours in any month.
EMPLOYERS’ NAMES AND MAILING ADDRESSES: (If more than 3 employers, please use additional forms.)
No. 1
No. 2
No. 3
EXPENDITURES (do not include the expenses of AMOUNT REIMBURSED BY EMPLOYERS TO LOBBYIST FOR EACH CATEGORY
preparing written testimony and exhibits for a
hearing before the council or an administrative
agency)
TotalAmount Not Attributable
Category Employer 1 Employer 2 Employer 3
AmountTo A Specific Employer
1.Preparation & distribution of
lobbying materials
2.Media
advertising
3.Telegraph, telephone, and other
forms of telecommunication
4.Postage
5.Fees and allowances
6.Entertainment
7.Food & beverages
8.Travel & lodging
9.Gifts
10.Loans
11.Other disbursements
TOTAL EXPENDITURES
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EXPENDITURES OF $25 OR MORE PER PERSON PER DAY
List in this section all expenditures incurred by you for the purpose of lobbying of $25 or more per person per day during the statement period.
This section is not applicable.
Expenditures incurred in the total sum of $25 or more per person per day were made for the following persons:
NameAddressAmount of value
AGGREGATE EXPENDITURES OF $150 OR MORE PER PERSON
List in this section all expenditures incurred by you for the purpose of lobbying in the total sum of $150 or more per person during the statement period.
This section is not applicable.
Expenditures incurred in the aggregate of $150 or more per person were made for the following persons:
NameAddressAmount of value
PART II. CONTRIBUTIONS TO LOBBYIST
List in this section all contributions received by you for the purpose of lobbying in the total sum of $25 per person during the statement period.
This section is not applicable.
Contributions in the total sum of $25 or more per person were received from the following persons:
NameAddressAmount of value
PART III. SUBJECT AREAS OF LEGISLATIVE AND/OR ADMINISTRATIVE ACTION
Legislative and/or administrative action in the following areas was supported or opposed during the statement period:
Economic development: Government-wide support:Employment:Other
: (Please indicate
commerce and industry, government financing, work opportunity, below)
trade and finance, taxation, revenue, working conditions,
tourism, agriculture appropriation, personnel, compensation,
services, employee funds unemployment and
disability compensation,
vocational rehabilitation
Environmental protection: Public safety: Transportation:
pollution control, environ- law enforcement and air, water, and land
mental preservation and corrections, safety from transportation facilities
enhancement physical disasters and services
Culture and recreation:Individual rights:Social problems:
cultural history and consumer protection, social services, public
events, recreational business and profes- assistance, housing
activities sional regulation of
services, legal assistance
I hereby certify that the statements made above are correct and complete to the best of my knowledge.
(Signature of Lobbyist) (Date)
05/09