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Agency of Inspector General
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Inspector General
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Lobbyist Registration Form
Lobbyist Registration Form
* Required Field
Your contact information
*First Name
*Last Name
Home Address
City
State
Zip Code
*Email
* Phone Number
Your Job Information
* Job Title
Business Address
City
State
Zip Code
* List all positions and time periods the Registered Lobbyist has held as an elected official, employee, or board member of a city, county or state.
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Do you have Individuals, Business, Organizations or other Entities which you have authorized to lobby on your behalf?
Yes
No
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Employees or Agents
Employees or agents are individuals, businesses, organizations, or other entities which you have authorized to lobby on your behalf.
* First Name
* Last Name
Home Address
City
State
Zip Code
* Phone Number
* Email
* List all positions and time periods Employee/Agent 1 has held as an elected official, employee, or board member of a city, county or state.
Business Address
Street Number
City
State
Zip Code
* Add another Employee/Agent
Yes
No
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Employee/Agent
* First Name
* Last Name
Home Address
City
State
Zip Code
* Phone Number
* Email
* List all positions and time periods Employee/Agent 2 has held as an elected official, employee, or board member of a city, county or state.
Business Address
Street Number
City
State
Zip Code
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Do you have Individuals, Businesses, Organizations or other Entities which have compensated you to lobby on their behalf?
No
Yes
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Clients
* First Name
* Last Name
Street Number
City
State
Zip Code
* Phone Number
* Email
Add Another Client?
Yes
No
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Client
* First Name
* Last Name
Street Number
City
State
Zip Code
* Phone Number
* Email
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Sign Electronically
I have been provided with the electronic website address for the Cuyahoga County Ethics Law (
http://code.cuyahogacounty.us/en-US/CCRC-T4.aspx
)
I agree I have read and I understand the pertinent sections of the Cuyahoga County Ethics Law
I agree to follow the pertinent sections of the Cuyahoga County Ethics Law
I acknowledge that I am responsible for periodically reviewing the Cuyahoga County Ethics Law to stay abreast of any pertinent amendments
Electronic Signature
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