STA TE 0F NE 
2016 Statement of Income and Expenses RECEIVED

 

 

 

 

for LOBBYISTS
(RSA Chapter 15) OCT 26 2015
PLEASE PRINT HAMPSHIRE
I DEPARTMENT OF STATE
I. Name of Lobbyist?)  MIDDLE
II. Name of lobbyist?s partnership. ?rm or corporati on1 if any:
14m 99ch Fort 7%05 N?o 
(Name of partnership? ?rm or corporation) 
Gown; ST #2121 Mi/ 03/01
Business Address: (Street) (Toxin/City) (side) (Zip Code)
((103) f3 03 ((003) 32? 4  S- e?mail  o?b

 

 

(Telephone) CF ma)

This statement covers: (Choose one - ?le separate reports for each client, OR you may ?le ll separate report for
reportable expense transactions which are not attributable to any one client).

Q/All reportable transactions occurring in the months prior to the reporting date relative to the following client:

For. PmoSmir/ - New 

(Full-Nam: of Client as it appears rm the Lobbyist Registration. ram.)
91;
All reportable transactions by the lobbyist (including the lobbyist's family). or the lobbying ?rm listed below which are
unrelated to any parocular client.

i
I

IV. Date ofReport April 27, 201.6 ?1 July 27, 2016 
Reports cover: ad?vt'gv from date of registration to 3/11/16 adivityfram 4.11/16 to 6661/16
October 27, 2016 [21? January 25, 2017 I3
activity from 7/1/16 to 9/30/16 aa?t'vity from 10/1/15 to 12/31/16

V. There have been no fees received and no reportable transactions made since the last report. 
If this box is checked, complete just thisfomi and submit it to the Secretary of State ?5 Q??ice, State HJHSE, Room 2011?,
Concord. NH 03301.

yheck ifadditional reports are attached:
If you have received fees or made expenditures, you must ?le Addendum Fees and Expenses

CI IfyOu have paid an honorarium or reimbursed expenses. you must file Addendum 8? Report ot'Honorariums or
 se Reimbursement
 If you, your ?rm, or your family has made political contributions, in1 must ?le Addendum Political Contributions

SVvorn Statemnt/Af?nnation by Lobbyist I 
I have read RS 15, RSA 15?13 and BSA 664 and hereby swear or af?nn that the foregoing information 15 time and complete

knowledge and belief. 1.
my 

?(31gnamrgmo '31) (Date) 
   

(Print Name of lobbyiSt)

  
  

 

 

STA TE 0F NE HAMPSHIRE

Lobbyists Fees and Expenses
Addendum A.

i
1

(RSA Chapter 15:6)

 

I. Name ofLobbyist(s) GEE (pork? 091225
Name oflobbyist?s partnership, ?rm or corporation, if any:

?memcnus Fart. P?ormezrt/r/UEW 

(Name of partnership. firm 6r corporation)
Date m/y/zo 


m. Name of Client  

IV. Fees Received

Indicate the gross amount of all fees received from the client Identi?ed abOve that are related, directly or indirectly,
to lobbying, including fees for sow-ices such as public advocacy, government relations, or public relations services
including research, moniroring legislation. and related legal work. The gross fee amount reported shall not be

reduced by any expenses:
71/ - ll

b) Total of all fees received this calendar year, prior to this reporting period b) 65/   
(This should equal the total of all prior reports for this calendar yearTotal of all fees received in this reporting period a) 

 

c) Total of all fees received to date

 

 

(Add lines a. and b) c) 
Indicate the amount of any such fees that are due, but have not 
yet been paid d) 
V. Expenses:

partnerships, firms, or corporations are required to report all expenses made from lobbying
fees. Separate reports are to be ?led for expenditures made relative to each client and if expenditures are made by
the that are unrelated to any one client. a separate report may be ?led for the lobbyisds??rm.
Expenses arc to be reported in one of three categories of expenses: (at) the aggregate total of all expenses paid
during the reportng period for salaries, benefits, support staff. and office expenses; the aggregate total of all
individual expenses where the erpenditure was of $25.00 or less (for example? meals purchased during a business
lunch where the cost was $25.00 or less, purchase of'a pen with a value of less than $10 that it: given?to the person
being lobbied, purchase of a ceremonial object given to a person being lobbied with a value of. $25.06) or less); and
an itemized statement of each indivrdual expenditure made during this reporting period of greater than $25.00 for
any purpose not covered by (for example: purchase of a. meal with Value of greater than $25, purchase of a
ceremonial object to be given to the subject of lobbying with a value greater than $25, but not greater than $50,
restaurant expenses for a legislative reception). Expenses for honorariums, expense reimbursement, or political
contributions will be reported on separate addendums and humid not be reported on Addendum A.

a) Total aggregate expenses for this reporting period for salaries, bene?ts,
support staff, and office expenses, related directly or indirectly to lobbying. a) 35

 

b) Total aggregate of expenditures during this reporting period not reported
in of $25 or less. b) 

 

c) Total of all itemized expenditures reported in detail in section VI c) 

 

 

d) Total expenses for this reporting period d) 
(Add lines a, and c)

Total of expenses paid this calendar year, prior to this reporting period c) 5

 

(This ShOuld be the amount on line of addendum A for last month?s report}

t) Total of all expenses year to date f) 

 

VI. Other Expenses:

Provide the following detail for at! expenditures of more than 325 made from lobbying fees during this reporting
period, including by whom paid or to whom charged.

Paid to: Amount:

5

 

 



 

 

 

 

 

 

 

 

 

 

Sworn Statement/Af?rmation by Lobbyist

I have read RSA 15, RSA 15-3 and BSA 664 and hereby swear or affirm that the foregoing information
is true and complete to the best of my knewledge and belief. I

721M, 

 

'(Sigmnirg?igb?yist) (pen

Game)? cog?E
(l?rint Name of lobbyist)

 

rumbme



 

TA TE 0F NE WHAMPSHIRE

Lobbyists Report of
Political Contributions

Addendum 
(RSA Chapter 15:6)

6' MOORE

Name of lobbyist?s partneirship, ?rm or corporation, if any:

_Ammi??t-?S New PSHIKEE
(Name of pernimhp. ?rm or corporation)
Date /0 


 

I. Name of Lobbyis?s)

Name of Client gm 

Political Contributions 

or each political connibuti on. that is reportable pursuant to RSA Chapter 664 paid on tehan of the
clientllobbyist and lobbying ?rm indicate the following:

 

 

372

Full name of candidate: ELL.

 

(ML-at Name) (First Name) (Middle ?NanE/I'niriar)
'3 
Amount of contribution CD 0 Of?ce Candidate is Seeking 7'5 I #3955

 

If the contnbution is an m-kind contribution, provide a description of the goods or services provided. and enter the
actual cost of the in-kind contribution on the line above for amount of contribution Ifthe actual cam 18 not known,
enter an, estimated value and the word "estimate 

 

 

 

 

 

meg!!-

Full name of candidate: ?75 
(Last Name) (First Name) (Middle Na: 1erlnitial)
Amount 0fCOIl?U'ibUtiOI?l 5 4  Of?ce Candidate 15    

 

 

If the contribution is an in-kind contribution, provide a description of the goods or services prowded, and enter the
actual cost of the in-lcind contribution on the line ubOve for amount of contribution. If the actual cost is not known,
enter an estimated value and the word "esrimate."

 

 

 

 

 

 

 


Full name of candidate: 9Y4 2
(Last Name) (rim Name) (Middle Name/Initial)
Amount of contribution 0 Office Candidate is Seeking l? SE

 

 

(turn over to continue 

 

If the contribution is an in-kmd contribution, pronride a description of the goods or Services provi :led, anfd enter the

aerial cost: of the in-kind contribution on the line above for amount of contdbutton. If the actual coat is inot known.
enter an estimated value and the word ?estimate.?

 

 

mm
(If more than three contributions wen: made, report additional contributions on separate addendum fonts.)

Sworn Statunenthf?nnalion by Lobbyist

Ihavc read RSA 15, RSA 1543 and RSA 664 and hcreby swear or af?rm that the foregoing information
is true and complete to the best of my knowledge and belief.

[6150/ 6

(Signanlre/aflro?bigrist) (Date;
MOM

(Print Name of