Lobbyist Reporting Form - Wyoming Secretary Of State Page 2
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1
2LOBBYIST REPORTING FORM
For Paid Advertising/Printed Literature to Support, Oppose, or Influence State Legislation
STATEMENT OF CONTRIBUTIONS & EXPENDITURES ANNUAL REPORT (WS 28-7-201(k))
Report covers the period May 1 to April 30
Association Name: ___________________________________
Phone: (____) _________________
Address: __________________________________________
Email: _______________________
City/State/Zip: ______________________________________
Names of Association Representative: _____________________________________________________
Signature of Representative: ____________________________________
Date: _____________
RECEIPTS
Date
Name
Amount
Total Receipts
EXPENDITURES
Date
Name
Amount
Total Expenditures
Make additional copies of this page if needed.
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