|Clerk of the House of Representatives|
Legislative Resource Center
B-106 Cannon Building
Washington, DC 20515
|Secretary of the Senate
Office of Public Records
232 Hart Building
Washington, DC 20510
Lobbying Disclosure Act of 1995 (Section 4)
|1. Effective Date of Registration|
|2. House Identification||Senate Identification|
REGISTRANT Organization/Lobbying Firm Self Employed Individual
|5. Contact name and telephone number||International Number|
CLIENT A Lobbying Firm is required to file a separate registration for each client. Organizations employing in-house lobbyists should check the box labeled “Self” and proceed to line 10. Self
|7. Client name|
10. Name of each individual who has acted or is expected to act as a lobbyist for the client identified on line 7. If any person listed in this section has served as a “covered executive branch official” or “covered legislative branch official” within twenty years of first acting as a lobbyist for the client, state the executive and/or legislative position(s) in which the person served.
|Name||Covered Official Position (if applicable)|
11. General lobbying issue areas (Select all applicable codes).
12. Specific lobbying issues (current and anticipated)
Education and advocacy of Bitcoin and other crypto-graphic based currencies.
13. Is there an entity other than the client that contributes more than $5,000 to the lobbying activities of the registrant in a quarterly period and either actively participates in and/or in whole or in major part supervises, plans, or controls the registrant’s lobbying activities?
|No --> Go to line 14.||Yes --> Complete the rest of this section for each entity matching the criteria above, then proceed to line 14.|
|Name||Address||Principal Place of Business|
14. Is there any foreign entity
a) holds at least 20% equitable ownership in the client or any organization identified on line 13; or
b) directly or indirectly, in whole or in major part, plans, supervises, controls, directs, finances or subsidizes activities of the client or any organization identified on line 13; or
c) is an affiliate of the client or any organization identified on line 13 and has a direct interest in the outcome of the lobbying activity?
|No --> Sign and date the registration.||Yes --> Complete the rest of this section for each entity matching the criteria above, then sign the registration.|
|Name||Street||Principal place of business||Amount of contribution|
|(city and state or country)||for lobbying activities|