Lobbyist Registration Form - Minnesota Campaign Finance And Public Disclosure Board
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1
2Minnesota
Campaign Finance
and
Public Disclosure Board
Suite 190 ~ Centennial Office Building ~ 658 Cedar Street ~ St Paul MN 55155-1603 ~ 651-539-1180 ~ 800-657-3889
Lobbyist Registration
under Minn. Stat. § 10A.03
Instructions
•
A separate registration must be completed for each association a lobbyist represents.
•
The registration is due in the Campaign Finance and Public Disclosure Board office within 5 days after the individual meets the
definition of lobbyist.
•
This form may be emailed to cf.board@state.mn.us or faxed to 651-539-1196; 800-357-4114
•
All information on this form or report is public information and may be published on the Board’s website at
•
Do not use pencil or red ink.
•
Board staff may also be reached by phone at 651-539-1187; 800-657-3889; or by email at:
cf.board@state.mn.us
Registration
:
New Registration
Amendment
. _________________________
Registration No
Registration as a lobbyist prohibits most gifts to officials. Please see
Lobbyist Handbook
for prohibitions.
Lobbyist Information
Name of Lobbyist
Telephone
(Daytime)
Address (line 1)
Email address (Required or write No Email)
Address (line 2)
City, State, Zip
Lobbyist employer (if any)
Association or Person Lobbyist Represents
Name of Association
(include explanation of initials)
Telephone
Address
City, State, Zip
Name and Title of Association Contact Person
Telephone
Website of Association (Required or write No Website)
Email address of Contact Person
This document is available in alternative formats to individuals with disabilities by calling 651-539-1180; 800-657-3889; or through the
Minnesota Relay Service at 800-627-3529.
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