Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM OMB No. 1124-0002; Expires May 31,202Q Supplemental Statement Pursuant to the Foreign Agents Registration Act of 1938, as amended U.S. Department of Justice Washington. DC 2053.0 For Six Month Period Ending 9/30/2018 (fascn.jdate} I- REGISTRANT 1. (a) Name of Registrant (b) Registration No. Capitol Media Group 6412 (c) Business Addresses) of Registrant 2021 L Street NW Suite 101-340 Washington DC20036 2. Has there been a change in the information previously furnished in connection with the following? (a) If an individual: (1) Residence addressfes) Yes □ No □ (2) Citizenship Yes □ No □ (3) Occupation Yes □ No □ (b) If an organization: (1) Name (2) Ownership dr control (3) Branch offices Yes □ Yes □ Yes □ No 0 No 0 No 0 (c) Explain fully all changes, if any, indicated in Items (a) and (b) above. IF THE REGISTRANT IS AN INDIVIDUAL, OMIT RESPONSE TO ITEMS 3,4, AND 5(a), ,3. If you.have previously filed Exhibit C*1, state whether any changes therein have occurred during this 6 month reporting period; Yes □ No 0 If yes, have you filed ar. amendment to the Exhibit C? Yes □ No □ If no. please attach the required amendment. I. The Exhibit C, for which no printed torn is provirlcd. consists or a miccopyot the emitter, articles onnoorporaiion.assoaatKin, antisy lawsor a registrant that is an: organisation. (A waiver of the reqamstnent to file an Exhibit C may be bbttiincil forgood cause upon written application to the Assistant Attorney General, Narional Security Division, U,S. Department of Justice,. Washington, DC 20530.) FORM NSD-2 Revised 05/17 Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM (PAGE 2) 4. (a) Have any persons ceased acting as partners, officers, directors or similar officials of the registrant during this 6 month reporting period? Yes “ No 3 If yes, furnish the following information: Name Position Date Connection Ended (b) Ha ve any persons become partners, officers,, directors or similar officials during this 6 month reporting period? Yes □ No E If yes, furnish the following information: Name Residence Address Citizenship Position Date Assumed 5. (a) Has any person named in Itcm4{b) rendered services directly in furtherance of the interests of any foreign principal? Yes □ No 3 Tf yes, identify each such person and describe the service rendered, (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) m other than a clerical or secretarial, or in a related or similar capacity? Yes Q No 0 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. E 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, fiirriish the following information: Name Position or Connection 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 □ No □ If no, list names of persons whohavenot filed the required statement, Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM 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 No S 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 □ Yds □ No 0 Date Acquired 9. In addition to those named iri Items 7 and 8, if any, list foreign principal(s)2 whom you continued to represent during the 6 month reporting period. 10; (a) Have you' filed exhibits for the newly acquired foreign principal(s), if any, listed in Item 8? Exhibit A3 Yes □ No □ Exhibit B4 Yes □ No □ If no, please attach the required exhibit. (b) Have there been any changes in the Exhibits A arid B previously filed for any foreign principal whom you represented during this six month period? Yes Q No □ Ifyes, have you filed an amendment to these exhibits? Yes □ No □ If no, please attach the required: amendment 2 The term "foreign principal", includes, in iidditfon to those defined ih Section 1(b) of tlieXct; an individual drgaritaitida any of whose activities are directly or indirectly supervised, directed, controlled,-financed, or subsidized inwholepr fin major part by a foreign government; foreign political party,, foreign organization or foreign individual.{See Rule 100(a) (9)). A registrant whorepre.scntsmoreTlum cnefordgn 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 underSecttoiiS of the Act: (See Rule.208,) 3. The Exhibit A, which is filed on Form NSD-3, sets: forth the.information requiredtobe disclosed concerning eaeh.foreign. principal. 4 The Exhibit B, which is filed on Form NSEM-, sets forth the information concerning the agreement or lmderstohdirig between the registrunt and die foreign principal. Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 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, dr 9 of this statement? Yes □ No 13 If yes, identify each foreign principal and describe in full detail yOur activities and services: 12, During this 6 month reporting period, haye you on behalf of any foreign principal engaged in political activity3 as defined below? No B Yes □ If yes, identify each such foreign principal and describe infull 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. 13. In addition to the above described activities, if any, have you engaged in activity on your own behalf which benefits your foreign principals)? Yes □ No 0 If yes, describe fully.5 * \ 5 “PoUtkal activity," asdefined in Section l(o) of the Act, means aiiy 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 UciitcdStates 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 ofa government of a foreign country or a foreign political party. Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM 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 □ No 0 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 From Whom Purpose Amount Total (b) RECEIPTS-FUNDRAISING CAMPAIGN During this 6 month reporting period, have you received, as part of a fundraising campaign7,8any money on behalf of any foreign principal named in Items 7,8, or 9 of this statement? Yes □ No E If yes, have you filed, an Exhibit Ds to your registration? If yes, indicate the date the Exhibit D was filed. (c) Yes □ No E Date RECEIPTS-THINGS OF VALUE During this 6 month reporting period, have you received any thing of value9 other than money from any foreign principal named in Items 7,8, or 9 of this statement, or from arty other source, for or in the interests of any such foreign principal? Yes □ No 0 If yes, furnish the following information: Foreign Principal Date Received Tiling of Value Purpose 6,7 A registrant is required to file an Exhibit D ifhe collects or receives contributions, loans, moneys, or other things of value for a foreign principal, us part of a fundra:s;ng campaign. (See Ruie 201(e)). 8 An Exhibit D, for which no primed form is provided, sets forth an account of ittonery 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 tp.gifts, interest free loans, expense free (ravel, favored stock purchases, exclusive rights, favored treatment over competitors, "kickbacks," and the like. Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 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 □ No E (2) transmitted monies to any such foreign principal? Yes □ No E If no, explain in full detail why there were no disbursements made on belialf of any foreign principal. iSI/A-no foreign principal ff yes, set forth below in the required detai 1 and separately for each foreign principal an account of such monies, including monies transmitted, if any, to each foreign principal. Date To Whom Purpose Amount Total Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM (PAGE 7) '(b) DISBURSEMENTS-THINGS OF VALUE During this 6 month reporting period, have you disposed of anything of value10 other than money in furtherance of or in connection with activities on behaifof any foreign principal named in Items 7. 8, or 9 of this statement? ■Yes. □ No 13 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 arid 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 in connection with any primary election, convention, or caucus held to, select candidates for political office? Yes □ No E If yes, furnish the following information: Date Amount or Tiling of Value Political Organization or Candidate Location of Event 10, U Things of valueincludebut arc not limitcdiogifts, tiucrest Tree loans. CNpccsc frec iravcl, fayored siockpurchases, excitative rights, favored treatment over competitors, •’kickbacks,'' and thelike. Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM (PAGES) V - INFORMATIONAL MATERIALS 16. (a) During this 6 month reporting period, did you prepare, disseminate or cause to be disseminated any informational materials? 2 Yes □ No E 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 0 If Yes, please forward the materials disseminated during the six month period to the Registration Unit for review. 17- Identify each such foreign principal. 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 IS If yes, identify each such foreign principal, specify amount, and indicate for what period of time. 19. During this 6 mbiith. reporting period, did your acti vities in preparing, disseminating or causing the dissemination of informational materials include the use of any of the following: D Radio or TV broadcasts □ Magazine or newspaper □ Motion picture films □ Advertising campaigns □ Press releases □ Pamphlets or other publications □ Lectures or speeches □ Other (specify) □ Letters or telegrams ___ ___________________ ____________ _____________________________ ___________________________________________ Electronic Communications □ Email □ Website.URL(s):_______________________________________________________________________ _____________________ ________________ ' □ Social media websites URL(s):;_________________________ _______________________________________________ _________________________________________ _ □ Other (specijy) . .................................................................................................................................................................................................... ................................... ; . 20. During this 6 rnomh reporting period, did you disseminate or cause to be disseminated informational materials among any of the following groups: □ Public officials □ Newspapers □ Libraries □ Legislators □ Editors □ Educational institutions D Q Civic groups or associations □ Nationality groups Government agencies □ Other (specify) N/A___________________ _ ........... ;, 21. What language wasused in the informational materials: □ English □ Other (specify,)_____________ ______________________________________________ 22. Did you file with the Registration Unit, U.S. Department of Justice a copy of each item of such informational materials disseminated Or caused to be disseminated during this 6 month reporting period? Yes P , No P 23 . Did you label each item of such informational materials with the statement required by Section 4(b) of the Act? Yes □ No □ 12 The term informational materials includes any oral, visual, grapltic. 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 tin 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 10/30/2018 5:07:20 PM Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM (PAGE 9) VI - EXECUTION In accordance with 28 LtS.C, § 1746, the undersigned sweats) or affirm(s) under penalty of perjury tbat he/she has (they have) read die 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 of the information contained in the attached Short Form Registration Statements), if any. insofar as such information is not within his/her (their) personal knowledge. (Date: of signature) (Print or type name under each signature or provide electronic signatureli) 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 anorgahi2ahon, except that the organization can, by power of attorney, authorize one or more individuals ta execute this statement on its. behalf. • Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 PM Received by NSD/FARA Registration Unit 10/30/2018 5:07:20 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/s'ne has (they have) read die 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 rnake(s) no representation as to truth or accuracy of the information contained in the attached Short Form Registration Statements), if any, insofar as such information is not within his/her (their) personal knowledge. (Date, of signature) (Print or type name under each signature or provide electronic signature 3) io • So zoit stems (C&m WHeiky Ca Cap,no 4