Received by NSD/FARA Registration Unit 01/30/2018'1:56:45 PM OMB No. 1124-0002; Expires May 31, 2020 Supplemental Statement Pursuant to the Foreign Agents Registration Act of 1938, as amended U.S. Department of Justice Washington, DC 20530 For Six Morilh Period Ending 11 /30/201 7 (Insert date) I - REGISTRANT 1. (a) Name of Registrant (b) Registration No. DAVIS GOLDBERG & GALPER, PLLC 6394 (c) Business Address(es) of Registrant 170.0 K STREET NW, WASHINGTON DC 20006 2. Has there been a change in the information previously furnished in connection with the following? (a) If ah individual: (1) Residence address(es) YesQ No n (2) Citizenship Yes □ No □ (3) Occupation Yes □ No □ Yes □ No 0 Yes □ No 0 Yes □ No 0 (b) If an organization: (1) Name ' (2) Ownership or control (3) Branch offices (c) Explain fully all changes, if any, indicated in Items (a) and (b) above. N/A IF THE REGISTRANT IS AN INDIVIDUAL, OMIT RESPONSE TO ITEMS 3,4, AND 5(a). 3. If you have previously filed Exhibit C\ state whether any changes therein have occurred during this 6 month reporting period. Yes □ No S If yes, have you filed an amendment to the Exhibit C? . Yes Q No □ If no, please attach the required amendment. t The Exhibit C, for which no printed form is provided, consists of a true copy of’the charter, articles ot incorporation, association, and by laws ot a registrant that is an organization. (A waiver of the requirement to file an Exhibit C may be obtained for good cause upon written application to the Assistant Attorney General, National Security Division, U.S. Department of Justice, Washington, DC 20530.) FORM NSD-2 Revised 05/17 Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM (PAGE 2) 4. (a) Have any persons ceased acting as partners, officers, directors or similar officials of the registrant'diirirfg this 6 month reporting period? Yes 0 No E If yes, furnish the following information: Name Position Date Connection Ended (b) Have any persons become partners, officers, directors or similar officials during this 6 month reporting period? Yes □ No 0 If yes, furnish the following information: Name Residence Address Citizenship Position Date Assumed 5. (a) Has any person named in Item 4(b) rendered services directly in furtherance of the interests of any foreign principal? Yes 0 No 0 If yes, identify each such person and describe the service rendered. N/A (b) During this six month reporting period, has the registrant hired as employees or in any other capacity, any persons who rendered or will render services to the registrant directly in furtherance of the interests of any foreign principal(s) in other than a clerical or Yes □ No 0 secretarial, or in a related or similar capacity? Name Residence Address Citizenship Position Date Assumed (c) Have any employees or individuals, who have filed a short form registration statement, terminated their employment or connection with the registrant during this 6 month reporting period? Yes □ No 0 If yes, furnish the following information: Name Position or Connection Date Terminated (d) Have any employees or individuals, who have filed a short form registration statement, terminated their connection with any foreign principal during this 6 month reporting period? Yes □ No 0 If yes, furnish the following information: Name Position or Cpnnection Foreign Principal Date Terminated 6. Have short form registration statements been filed by all of the persons named in Items 5(a) and 5(b) of the supplemental statement? Yes 0 No 0 If no, list names of persons who have not filed the required statement. N/A Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM (PAGE 3) II - FOREIGN PRINCIPAL 7. Has your connection with any foreign principal ended during this 6 month reporting period? If yes, furnish the following information: Foreign Principal Yes □ No 0 Date of Termination 8. Have you acquired any new foreign principal(s)2 during this 6 month reporting period? If yes, furnish th following information: Name and Address of Foreign Principal(s) Yes □ No 0 Date Acquired 9. In addition to those named in Items 7 and 8, if any, list foreign principal(s)2 whom you continued to represent during the 6 month reporting period. DMYTRO FIRTASH 10. (a) Have you filed exhibits for the newly acquired foreign principal(s), if any, listed in Item 8? Exhibit A3 Yes Q No □ Exhibit B4 Yes □ No □ If no, please attach die required exhibit. (b) Have there been any changes in the Exhibits A and B previously filed for any foreign principal whom you represented during this six month period? Yes □ No 0 If yes, have you filed an amendment to these exhibits? Yes □ No □ If no, please attach the required amendment. 2 The term "foreign principal" includes, in addition to those defined in Section 1(b) of the Act, an individual organizationally of whosTactivities are directly or indirectly supervised, directed, controlled, financed, or subsidized in whole or in major pan by a foreign government, foreign political party, foreign organization or foreign individual. (See Rule 100(a) (9)). A registrant who represents more than one foreign principal is required to list in the statements he files under the Act only those principals for whom he is not entitled to claim exemption under Section 3 of the Act. (See Rule 208.) 3 The Exhibit A, which is filed on Form NSD-3, sets forth the information required to be disclosed concerning each foreign principal. 4 The Exhibit B, which is filed on Form NSD-4, sets forth the information concerning the agreement or understanding between the registrant and the foreign principal. Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM (PAGE 4) III - ACTIVITIES 11. During this 6 month reporting period,- have you engaged in any activities for or rendered any services to any foreign principal named in Items 7, 8, or 9 of this statement? Yes G3 No □ If yes, identify each foreign principal and describe in full detail your activities and services: DMYTRO FIRTASH: Registrant has provided legal representation in ongoing matters, including strategies and.services in support of principal's legal and litigation positions, At times, these services may include correcting the record in the media and elsewhere in the face of distortions and inaccuracies arid advising oh such media strategies for such purposes. 12. During this 6 mdnth reporting period, have you on behalf of any foreign principal engaged in political activity5*as defined below? Yes 0 No □ If yes, identify each such foreign principal and describe in full detail all such political activity, indicating, among other things, the relations, interests and policies sought to be influenced and the means employed to achieve this purpose. If the registrant arranged, sponsored or delivered speeches, lectures or radio and TV broadcasts, give details as to dates, places of delivery, names of speakers and subject matter. DMYTRO FIRTASH: Registrant has provided legal representation in ongoing matters, including strategies and services in support of principal's legal and litigation positions. At times, these services may include correcting the record in the media and elsewhere in the face of distortions arid inaccuracies and advising on such media strategies for such purposes. See also Attachment A. 13. In addition to die above described activities, if any, have you engaged in activity on your own behalf which benefits your fofeign principal(s)? Yes □ No S If yes, describe fully. 5 "Political activity," as defined in Section l(o) ofthe Act, means any activity that the person engaging in believes will, or that the person intends to, in any way influence any agency or official of the Government of the United States or any section of the public within the United States with reference to formulating, adopting or changing the domestic or foreign policies of the United States or with reference to political or public interests, policies, or relations of a government of a foreign country or a foreign political party. Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM (PAGE S') IV - FINANCIAL INFORMATION 14. (a) RECEIPTS-MONIES During this 6 month reporting period, have you received from any foreign principal named in Items 7, 8, or 9 of this statement, or from any other source, for or in the interests of any such foreign.principal, any contributions, income or money either as compensation or otherwise? Yes 0 No □ If no,-explain why. If yes, set forth below in the required detail and separately for each foreign principal an account of such monies:6 Date 9/18/2017 From Whom DMYTRO FIRTASH Purpose Amount PAYMENT OF FEES $25,000.00 $25,000.00 Total (b) RECEIPTS - FUNDRAISING CAMPAIGN During this 6 month reporting period, have you received, as part of a fundraising campaign7, any money on behalf of any foreign principal named in Items 7,8, or 9 of this statement? Yes CD No B If yes, have you filed an Exhibit D8 to your registration? If yes, indicate the date the Exhibit D was filed. (c) Yes □ No □ Date RECEIPTS-THINGS OF VALUE During this 6 month reporting period, have you received any thing of value9 other that money from any foreign principal named in Items 7,8, or 9 of this statement, or from any other source, for or in the interests of any such foreign principal? Yes □ No B If yes, furnish the following information: Foreign Principal Date Received Thing of Value Purpose 6,7 A registrant is required to file an Exhibit D if he collects or receives contributions, loans, moneys, or other things of value fora foreign principal, as part of a fundraising campaign. (See Rule 201(e)). 8 An Exhibit D, for which no printed form is provided, sets forth an account of money collected or received as a result of a fundraising campaign and transmitted for a foreign principal. 9 Things of value include but are not limited to gifts, interest free loans, expense free travel, favored stock purchases, exclusive rights, favored treatment over competitors, "kickbacks," and the like. Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM (PAGE 6) 15. (a) DISBURSEMENTS-MONIES ~ ’ " •' During this 6 month reporting period, have you (1) disbursed or expended monies in connection with activity on behalf of any foreign principal named in Items 7,8, or 9 of this statement? Yes 0 No □ (2) transmitted monies to any such foreign principal? Yes □ No IS If no, explain in full detail why there were no disbursements made on behalf of any foreign principal. If yes, set forth below in the required detail and separately for each foreign principal an account of such monies, including monies transmitted, if any, to each foreign principal. To Whom Date Purpose Amount 9/11/2017 United Airlines Airfare $789.40 9/11/2017 Royal 3 CCC, City Service & Taxi Taxi Fare $130.00 9/11/2017 REDTOP Taxi Fare $205.00 $1,124.40 Total Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM (PAGE 7) (b) pISBL RSEMENTS-THINGS OF VALUE During this 6 month reporting period, haVe you disposed of anything of value'0 other than money in furtherance of or in connection with activities on behalf of any foreign principal named in Items 7, 8, or 9 of this statement? Yes □ No IEI If yes, furnish the following information: Date (c) Recipient Foreign Principal Thing of Value Purpose DISBURSEMENTS-POLITICAL CONTRIBUTIONS During this 6 month reporting period, have you from your own funds and on your own behalf either directly or through any other person, made any contributions of money or other things of value11 in connection with an election to any political office, or'ifl connection with any primary election, convention, or caucus held to select candidates for political office? Yes H No □ If yes, furnish the following information: Date Amount or Thing of Value Political Organization or Candidate Location of Event By Short Form Registrant tinny Davis: 06/21/2017 $250.00 Friends of Cheryl Glenn (MD) N/A 08/03/2017 $250.00 George P. Bush for Texas Land Commissioner N/A 10,11 Things of value include but arc not limited to gifts, interest free loans, expense free travel, favored stock purchases, exclusive rights, favored treatment over competitors, "kickbacks," and the like. Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM (PAGE 8) V - INFORMATIONAL MATERIALS 16. (a) During this 6 month reporting period, "did you prepare, disseminate or cause to be disseminated any informational materials?12 Yes 0 No □ If Yes, go to Item 17. (b) If you answered No to Item 16(a), do you disseminate any material in connection with your registration? Yes □ No □ If Yes, please forward the materials disseminated during the six month period to the Registration Unit for review. 17. Identity each such foreign principal. DMYTRO FIRTASH 18! During this 6 month reporting period, has any foreign principal established a budget or allocated a specified sum of money to finance your activities in preparing or disseminating informational materials? Yes □ No (3 If yes, identify each such foreign principal, specify amount, and indicate for what period of time. 19. During this'6 month reporting period, did your activities in preparing, disseminating or causing the dissemination of informational materials include the use of any of the following: □ Radio or TV broadcasts □ Magazine dr newspaper □ Motion picture films □ Letters or telegrams Q Advertising campaigns 0 O Pamphlets or other publications G Lectures or speeches Press releases □ Other (specify) Electronic Communications 0 Email □ Website URL(s):;;. G Social media websites URL(s):. G Other (specify) _.. 20. During this 6 month reporting period, did you disseminate or cause to be disseminated informational materials among any of the following groups: Q Public officials □ Legislators 0 Newspapers 0 Editors Q Libraries Q Government agencies □ Civic groups or associations G Nationality groups G Educational institutions □ Other (specfy)__________ 21. What language was used in the informational materials: E English G Other (specify)______ 22. Did you file with the Registration Unit, U.S. Department of Justice a copy of e"ach' itehTbf such- informational materials disseminated or caused to be disseminated during this 6 month reporting period? Yes S No G 23.. Did you label each item of such informational materials with the statement required by Section 4(b) of the Act? Yes 0 No G 12 The term informational materials includes any oral, visual, graphic, written, or pictorial information or matter of any kind, including that published by means of advertising, books, periodicals, newspapers, lectures, broadcasts, motion pictures, or any means or instrumentality of interstate or foreign commerce or otherwise. Informational materials disseminated by an agent of a foreign principal as part of an activity in itself exempt from registration, or an activity which by itself would not require registration, need not be filed pursuant to Section 4(b) of the Act. Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM (PAGE 9) ______ _ - _________ # VI - EXECUTION In accordance with 28 U.S-C. § 1746, the undersigned sweats) or affirm(s) under penalty of perjury that he/she has (they have) read the information set forth in this registration statement and the attached exhibits and that he/she is (they are) familiar with the contents thereof and that such contents are in their entirety true and accurate to the best of his/her (their) knowledge.and belief; except that.the undersigned make(s) no representation as to truth or accuracy ofthe information contained in the attached Short Form Registration Statement(s), if any, insofar as such information is not within his/her (their) personal knowledge. (Date of signature) January 30,2018______________________ (Print or type name under each signature or provide electronic signature13) /$/ Lanny J. Davis eSigned 13 This statement shall be signed by the individual agent, if the registrant is an individual, or by a majority of those partners, officers, directors or persons performing similar functions, if the registrant is ah organization, except that the organization can, by power of attorney, authorize one or more individuals to execute this statement on its behalf. Received by NSD/FARA Registration Unit 01/30/2018 1:56:45 PM