Received by NSD/FARA Registration Unit 02/12/2018 3:21:59 PM
OMB No 1124-0005; Expires May 31. 2020

Short Form Registration Statement
Pursuant to the Foreign Agents Registration Act of
1938, as amended

U.S. Department of Justice
Washington. DC 20530

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INSTRUCTIONS. Each partner, officer, director, associate, employee, and agent of n registrant is required to (ilea short form registration statement
unless he engages in no activities in furtherance of the interests of the registrant's loreign principal or unless the services he renders to the registrant
an in a secretarial, clerical, or in a related or similar capacity. Compliance is accomplished by ftling an electronic short form registration statement
Privacy Act Statement. The filing of this document is.rcquircd for the Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 c</«•</.
for the purposes of registration under the Act and public disclosure. 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 documentor 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 the
.fara.gov. One copy of
Registration Unit in Washington. DC. Statements arc also available online at the Registration Unit’s webpage: https:
every such document, other than informational materials, is automatically provided to the Secretary orSiatc pursuant to Section .6(b) of the Act, and
copies of any and all documents arc routinely made available to other agencies, departments and Congress pursuant to Section 6(c) of the Act. The
Attorney General also transmits a semiannual report to Congress on the administration of the Act which lists the names of all agents registered under
the Act and the foreign principals they represent. This report is available io the public and online at: https:/.'vs\\w.rar.i.gns.
Public Reporting 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, gatltcring and maintaining the data heeded, and completing’and rcvicwmgTlic
collection of information. Send comments regarding this burden estimate or any other aspect of this collection of info'rmation, including suggestions
for reducing this burden To Chief, Registration Unit. Counterintelligence and Export 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 2G5Q3.
I. Name

2. Rcaistration No.

a.

Ana Gabriela Fernandez
3. Residence Addrcss(cs)
1512 Corcoran St. NW, Apt 21. Washington, D.C. 20009

4. Business Addresses)
1615 L St. NW, Floor 10. Washington, D.C. 20036

5. Year of Birth

6. If present citizenship was not acquired by birth,
indicate when, and how acquired.

Nationality

1988
U.5. and Venezuelan

Present Citizenship U.S, and Venezuelan
7. Occupation Associate

8. Wtat is the name and address of the primary rc6istranl?
Nnme CLS Strategies

9. Indicate your connection with'thc primaryrcgistrant:
□ partner
□ director
□ officer

□ associate

,MS fit MW. Boor 10. Washington, O.C. 20036
Addre“

El employee

□ consultant

□ agent

□ subcontractor

Q other (specify)____________________________
10. List ever)' foreign principal to whom you will render services in support of the primary registrant.
Government of Peru

I. 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 the datc(s) of such services, (ifspace is insufficient, a fuff insert page must be
KiCi/J

To provide strategic communications support and counsel to the Government of Peru. This may Include creating
communications materials as needed, distributing materials, and interfacing with the media.

FORM NSD-6
Revised05 I?

Received by NSD/FARA Registration Unit 02/12/2018 3:21:59 PM

 Received by NSD/FARA Registration Unit 02/12/2018 3:21:59 PM
12. Do any of the above described services include political activity asdefined in Section l(o> of the Act and in the footnote below''
Yes®

No □

If yes. describe separately and in detail such political activity.
See answer to Question 11.

13. The scrviccs'descnbcd in Items 11 and 12 are to be rendered on a
O full time basts

® part lime basis

Q special basis

M. What compensation or thing of value have you received to date or will you receive for the above services?
□ Salary: Amountsper____________

□ Commission at%of

0 Salary: Not based solely on services rendered to the foreign pnncipal(s).
□ Fee: Amount $____________

□ Other thing of value

15. During die period beginning 60 days prior tolhe.date of your obligation to register i.o the time of filing this statement, did you
make any contributions of money or other things 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 □
No®
If yes, furnish the following information:
Amount or Thing of Value

Political Organization or Candidate

Location of Event

EXECUTION
In accordance with 28U.S.C. § 1746. the undersigned swears or affirms under penalty of perjury that hc/shc has read the
information set forth in this registration statement and that he'she is familiar with the contents thereof and that such contents arc in
their entirety true and accurate to the best of his/her knowledge and belief.

CO locbl'ln/\r-b
(i>atc ufsifenhritre}

(Signature)

Ffli'iiwnc: “Political-activity." as defined in Section l(o)<>t the’Aci, means any activity which the person engaging in believes will, or'ihai the person intends in. in any way influence
any agency or official uftheCiaicmnicni of the United Stales 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 io the political or public interests, policies, or relations of a goicmmcM of a foreign country or a foreign political
party-

Received by NSD/FARA Registration Unit 02/12/2018 3:21:59 PM