Received by NSD/FARA Registration Unit 02/02/2018 12:52:23 PM QMB No. 1124*0005; Expires May 31,2020 u.s. Department of Justice Short Form Registration Statement Pursuant to the Foreign Agents Registration Act of 1938, as amended Washington, pc 20530 INSTRUCTIONS. Each partner, officer, director, associate, employee, and agent of a registrant is required to file a short form registration statement unless he engages in no activities in furtherance of foe interests of tie registrant' s foreign principal or unless foe services Ire renders to foe registrant are in a secretarial, clerical, or in a related or similar capacity'. Compliance is accomplished by filing an electronic short form registration statement at httpfi://www fara-gov- Privacy Act Statement The filing of this document is required for foe Foreign Agents RegistrationActof 1938, as amended, 22 U.S.C. § 611 etseq., for foe purposes of registration under the Act and public direlosure. Provision of the information requested is mandatory, and failure to provide the information is subject to the penalty and enforcement provisions established in Section 8 of the Act, Every registration statement short form registration statement supplemental statement exhibit, amendment copy of informational materials or other document or information filed with the Attorney General under this Act is a public record open to public examination, inspection and copying during the posted business hours of foe Registration Unit in Washington, DC. Statements are also available online atthe Registration Unit's webpage: https://www.fara.gov. One copy of every such document other than informational materials, ^automatically provided to the Secretary of State pursuant to. Section 6(b) of foe Act, and copies of any and all documents are routinely made available to other agencies^ departments and Congress pursuant to Section 6(c) of the Act. The Attorney General also transmits a semi-annual report to Congress on foe administration of the Act which lists foe names of ail agents registered under the Act and the foreign principals they represent This'report is available to for public and online at https://www.fara.gov. Public Repotting Burden. Public reporting burden for this collection of information is estimated to average .429 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding; this burden estimate or any other aspect of this collection of information, inrhiHing suggestions for reducing this burden to Chief, Registration Unit, Countcrintclligcnccand Expoit Control Section, National Security Division, U.S. Department of Justice, Washington, DC 20530; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. 1. Name 2. Registration No. Matthew Epperfy 3. Residence Addresses) 37 Briar Patch Road Osterville, MA 02655 4. Business Address(es) 5. Year of Birth 1980 6. If present citizenship was not acquired by birth, Nationality American 300 M StreetSuite402 Washington, DC 20003 infocate when, and how acquired. Present Citizenship USA 7. Occupation Public affairs consultant 8. What is the name and address of foe primary registrant? Name Chartwefl Strategy Group, LLC Address 300 M Street SE, Suite 402 Washington, DC 20003 □ partner □ director □ employee □ consultant □ officer H other (specify) Member □ associate ____________ Q agent □ subcontractor 10. List every foreign principal to whom you will render services in support of the primary registrant. Government of Georgia 11. Describe separately and in detail all services which you will render to the foreign principals) listed in Item 10 either directly, or through the primary registrant listed in Item 8, and foe date(s) of such services. (Ifspace is insufficient, afull insert page must be used.) Will provide public affairs consulting services to strengthen U.S.-Georgia bilateral relations. FORM NSD-6 Revised 05/17 Received by NSD/FARA Registration Unit 02/02/2018 12:52:23 PM Received by NSD/FARA Registration Unit 02/02/2018 12:52:23 PM 12. Do any of die above described services include political activity as defined in Section 1 (o) of die Act and in the footnote below? Yes H No □ If yes, describe separately and in detail such political activity. Will conduct meetings with policymakers and opinion leades and outreach to media, think tanks, business experts, academics about the bilateral relationship. 13. The services described in Items 11 and 12 are to be rendered on a □ full time basis S part time basis □ special basis 14. What compensation or thing of value have you received to date or will you receive for the above services? □ Salaiy: Amount!per____________ □ Commission at% of 0 Salary: Not based solely on services rendered to die foreign principals). □ Fee: Amount !____________ □ Other thing of value __ 15. During the period beginning 60 days prior to the dateof y^urobligationto register io the time of filing this statement, did you make any contributions of money or other dungs of value from your own funds or possessions and on your own behalf in connection with any election to political office or in connection with any primary election, convention, or caucus held to select candidates for any political office? Yes O No El If yes, furnish the following information: Date Amount or Thing of Value Political Organization or Candidate Location of Event EXECUTION In accordance with 28 U.S-C. § 1746, die undersigned swears or affirms undo1 penalty of perjury that he/she has read the information set forth in this registration statement and that he/she is familiar with the contents thereof and that such contents are in their entirety true and accurate to die best of his/her knowledge and belief. g/zy /g (Date ofsignature) d Footnote: "Political activity," as defined in Section l(o) of the Act, means any activity which the person engaging in believes will, or that the person intend* to,' inaaywny mflnence any agency or office of tie Government of foe United State* or any taction of the public within the United Stoles with reference to’ formulating, adopting, or changing the domestic or foreign policies of the United States or with reference to the political or public interests, policies, or relations of a government of a foreign country or a foreign political fwty- Received by NSD/FARA Registration Unit 02/02/2018 12:52:23 PM