New Mexico Secretary of State?s Office 325 Don Gaspar, Suite 300 Santa Fe, New Mexico 87501 Telephone: (505) 827-3600 1 Toli Free: (800) 477-3632 Fax: (505) 827-8403 Email: sos.ethics@state.nm.us organlzatlon of two or more persons, IncludIng an InszIdual who makes any representation as beIng an organIzatIon that withIn one calendar 33 ear expends funds' In excess of two thousand five hundred doilars 500) not otherwise reported under the iobbyist Regulation Act to conduct {an advertising campaign for the purpose of lobbying shail register with the secretary of state within forty-eight hours after expending two housand five hundred dollars 500), see . register, please complete and file this Registration Form with the Secretary of State?s Office. The law requires the following information be disclosed: the name of the organization and the names, addresses and occupations of any of its principals, organizers or officers and the name of any iobbyist or lobbyist?s employer who is a member of the organization. Thereafter, within 15 days after a legislative session, the organization is required to file a report of expenditures and contributions with the Secretary of State including he contributions, pledges to contribute, expenditures and commitments to expend for the advertising campaign. To file the above mentioned __report please complete the LobbyIst Advertising CampatgnReportIng Form and timely submit it to our office. RegIstratIon Year 39L WW 1. Complete Name of Organization or Individual Conducting Advertising Campaign Telephone Everytown for Gun Safety Action Fund (646) 324-8250 2. Business Address (street address, city, state zip) Email Address: PO Box 4184, New York, NY 10163 lobbyreg@everytown.or% 3. Mailing Address (if different than business address) 4. Full Name of Person Completing this Registration Form Tara Paone 4a. Your Telephone Number Email Address (646) 324?8250; iobbyreg@everytown.org Richard DeScherer PO Box 4184, New York, NY 10163 Chairman Diane PO BOX 4184, New York, NY 10163 Secretary Treasurer Michael Best PO Box 4184, New York, NY 10163 Director . Jason Post PO Box 4184, New York, NY 10163 Director John Feinblatt PO Box 4184, New York, NY 10163 President Tara Paone PO BOX 4184, New York, NY 10163 Chief Financial Officer Page 1 of 2 REGISTRATION FORM FOR LOBBING ADVERTISING . Organization: Name and Title Address Occupation Richard DeScherer PO Box 4184, New York, NY 10163 Chairman John Feinblatt PO Box 4184, New York, NY10163 President Diane Gubelli PO Box 4184, New York, NY 10163 Secretary Treasurer 7. List all Lobbyists or Lobbyist?s Empioyer Who are Members of the Organization, if none, write ?none.? Full Name of Each Lobbyist Complete Name of Each Lobbyist Employer Everytown for Gun Safety Action Fund is a registered lobbyist employer. I hereby swear or affirm under penalty of law that all the information on this form is true, correct and complete to the best of my knowledge. ??Sig??ureWof Frincipai, Organizer or Officer I I Date Page 2 of 2 4f.? :3 {Lee} .. 3? Ps Ls 55 Reportan Form . Ci: a - 0F TATE NG PAIGN New Mexico Secretary of Sta?e?s Office 325 Don Gaspar, Suite 300 Santa Fe, New Mexico 87501 Teiephone: (800) 477-3632 Fax: (505) 827?8403 Everytown for Gun Safety Action Fund Business Address PO Box 4184 Email Address Telephone lobbyreg@everytown.org (646) 324-8250 Name of Contact Person Tara Paone Email Address Telephone I0bbyreg@everytown.org (646) 324-8250 E): 1/23/2017 Polling 5,438.75 1/24/2017 Patch Through Cails 3,093-75 1/25/2017 Ad Production 10,270.00 2/6/2017 Patch Throuqh Calis 31453142 2/9/2017 Ad Production 17,028.28 2/14/2017 Patch Through Calls 500'00 2/21/2017 Patch Throuqh Calls 500'00 2/27/2017 Th ?3 500.00 Continued Pagei of 4 -Loee New Mexico Secretary of State?s U?ice 325 Don Gaspar, Suite 300 Santa Fe, New Mexico 87501 Telephone: (800) 477-3632 Fax: (505) 827?8403 Please iype .Copy this form as necessary. NME Everytown for Gun Safety Action Fund Business Address PO Box 4184 Email Address Telephone iobbyreg@everytown.org (646) 324-8250 Name of Contact Person Tara Paone Email Address Telephone lobbyreg@everytown.org (545) 324?8250 usesmo ?nnamen maexeeno 115.3 3/5/2017 Patch Throuqh Calls 500.00 3/8/2017 Patch/Thrown Calls 500-00 3/15/2017 Polling 2,682.81 3/20/2017 Patch Throuoh Calls 16194138 1/4/2017 Rent for Phone Bank Space 100.00 2/5/2017 Office Supplies 89.58 2/8/2017 Rank Spam 100 on 2/9/2017 Office Supplies . 150.46 I Continued Pagez of 4 VEAWSENG SAM PAEGN Reporting Form New Mexico Secretary of State?s Office 325 Don Gaspar, Suite 300 Santa Fe, New Mexico 87501 Telephone: (800) 477-3632 Fax: (505) 827-8403 Pie Copy this term as necessary RIZIN Everytown for Gun Safety Action Fund Business Address PO Box 4184 Email Address Teiephone iobbyreg@everytown.org (646) 324?8250 Name of Contact Person Tara Paone Emaii Address Yelephone iobbyreg@everytown.org - (646) 324-8250 2/17/2017 Digital Ads 63255 2/20/1201 7 Digital Ads 647.07 2/23/2017 Digital Ads 645.23 2/24/2017 Digital Ads 278.69 65,061.97 Page 3of4 Nai Appiicabie I hereby swear or affirm, under penalty of law, that all Ehe information on this form, inciuding any attachments, is true, correct and complete to the basi 9f my knowledge. . ChiefFinanciai Officer 323, ll'W [ll/7 SIGNATURE of Principal, Organizer or Officer Title ?Date Page 4 of 4