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Apple_Inc__CUP_REGISTRATION_2022_09_06CITY OF CUPERTINO LOBBYIST REGISTRATION & REPORTING FORM (CMC CH. 2.100) Total Number of Pages ŝŶĐůƵĚŝŶŐĂĚĚŝƚŝŽŶĂůƉĂŐĞƐ dzWK&ZWKZd(check all that apply) Initial Registration Annual Renewal (filed annually by January 15) Termination͕ effective date: Amendment͕filed onĚĂƚĞ͗ Amendment explanation: ________________________________________________ Quarterly Report (CMC 2.100.100) (check one ďelow) ϭƐƚƋƵĂƌƚĞƌͲ:ĂŶƵĂƌǇϭƚŽDĂƌĐŚϯϭ;ĨŝůĞĚďǇƉƌŝůϭϱͿ ϮŶĚYƵĂƌƚĞƌͲƉƌŝůϭƚŽ:ƵŶĞϯϬ;ĨŝůĞĚďǇ:ƵůǇϭϱͿ ϯƌĚYƵĂƌƚĞƌͲ:ƵůǇϭƚŽ^ĞƉƚĞŵďĞƌϯϬ;ĨŝůĞĚďǇKĐƚŽďĞƌϭϱͿ ϰƚŚYƵĂƌƚĞƌͲKĐƚŽďĞƌϭƚŽĞĐĞŵďĞƌϯϭ;ĨŝůĞĚďǇ:ĂŶƵĂƌǇϭϱͿ Section 1 LOBBYIST INFORMATION Are you a: Contract Lobbyist Business or Organization Lobbyist Expenditure Lobbyist Note: Contract Lobbyist, Business or Organization Lobbyist, and Expenditure Lobbyist are defined in CMC 2.100.030(o). Name of Lobbyist Telephone Number Business Address (Number and Street) City State Zip Code Cupertino Business License Number City of Cupertino Lobbyist Registration & Reporting Page 1 of 8 DBA Federal Employer Identification Number (FEIN) Specify how the Contract Lobbyist, Business or Organization Lobbyist, or the Expenditure Lobbyist entity is organized: Sole Proprietorship Partnership Non-Profit Corporation For-Profit Corporation Other: If the Lobbyist is a sole proprietor or partnership of fewer than ten (10) persons, state the name(s) of the sole proprietor or persons with an ownership interest in the business:______________________________________________________________________ If the Lobbyist is a corporation (for-profit or non-profit), state the name(s) of corporate Officers and the Agent for Service of Process and their respective contact information (if different from above):________________________________________________________________________ _________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Section 2 REPORT FOR EACH CATEGORY OF LOBBYIST CONTRACT LOBBYIST (CMC 2.100.090(a)) CLIENT INFORMATION Client Name, Address, and Telephone Number Effective Date of Representation City of Cupertino Lobbyist Registration & Reporting Page 2 of 8 Specify the nature and purpose of the client's business Describe the legislative or administrative action(s) the Contract Lobbyist was retained to influence on behalf of the client, and the outcome sought (attach additional pages if necessary). Name of each person working for the Contract Lobbyist that is engaged in lobbying activity on behalf of the client: ADDITIONAL CLIENTS If the contract lobbyist represents more than one client, attach a separate page providing all of the above information for each additional client. BUSINESS OR ORGANIZATION LOBBYIST (CMC 2.100.090(b)) Name of Business Name of owners, officers or employees conducting Lobbying activities on behalf of Business or Organization: Describe the nature and purpose of the business, organization, or association. The legislative of administrative action(s) the business or organization lobbyist seeks to influence ;Attach additional pages if necessary.Ϳ EXPENDITURE LOBBYIST (CMC 2.100. 090(c)) City of Cupertino Lobbyist Registration & Reporting Page 3 of 8 Name of Expenditure Lobbyist Name of each person working for the Expenditure Lobbyist that is engaged in lobbying activity (if applicable): The legislative of administrative action(s) the expenditure lobbyist seeks to influence Amount of Payment(s) or Expenditure(s): $____________________________________________ Section 3 PAYMENT FOR CONSULTANT OR OTHER SERVICES RENDERED TO CITY, CITY OFFICIALS, ETC. (CMC 2.100. 090(d)) Name of Payer (e.g. City agency, City Official or City Official- elect, ballot measure committee) Name of Recipient Lobbyist Amount of Payments(s) Date(s) of Payment(s) CAMPAIGN CONTRIBUTIONS (CMC 2.100.090) Name of Lobbyist Making or Delivering Contribution Name of Contribution Recipient (Officeholder, Candidate, or Candidate- Controlled Committee) Date of Contribution Amount of Contribution City of Cupertino Lobbyist Registration & Reporting Page 4 of 8 ;Attach a separate page providing all of the above information for additional contributions as needed.Ϳ INDEPENDENT EXPENDITURES (CMC 2.100. 090(g)) Name of Lobbyist Making Independent Expenditure Name of City Official or candidate for City office that is intended beneficiary of Independent Expenditure Date of Expenditure Amount of Expenditure ;Attach a separate page providing all of the above information for additional expenditures as needed.Ϳ FUNDRAISING ACTIVITY (CMC 2.100.090(h)) Name(s) of beneficiary of Fundraising Activity (City Official, candidate, committee, or party) Name of City Official requesting Fundraising Activity (if applicable) Date of Fundraising Activity Name(s) of contributors who made contributions in connection with Fundraising Activity Amount(s) of contributions raised in connection with Fundraising Activity ;Attach a separate page providing all of the above information for additional expenditures as needed.Ϳ DONATIONS TO ORGANIZATIONS MADE AT BEHEST OF CITY OFFICIAL OR (CANDIDATE CMC 2.100.090(i)) Recipient of Donation (for profit or nonprofit Organization) Amount(s) of Donation(s) Date(s) of Donation(s) City of Cupertino Lobbyist Registration & Reporting Page 5 of 8 Note: only donations totaling more than $1000 in the aggregate per calendar year must be disclosed. CONTACTS WITH CITY OFFICIALS OR CITY OFFICIALS-ELECT (CMC 2.100.090(j)) Name(s) of City Official(s) or City Official(s)-Elect contacted Date(s) of Contact Methods(s) of Contact Approximate Number of Contacts during calendar year: One Contact Two to Five Contacts Six to Ten Contacts Eleven or More Contacts ACTIVITY EXPENSES (CMC 2.100.090(k)) Beneficiary or recipient(s) of Activity Expense(s) (City Official, City Official- elect or member of his or her immediate family or domestic partner) Amount(s) of Activity Expense(s) Date(s) of Activity Expense(s) Note: Activity Expenses include Gifts, honoraria, consulting fees, salaries and other forms of Compensation, but do not include campaign contributions. Section 4 TERMINATION (2.100.060) I certify that I have been authorized by the Lobbyist identified above to make this verification. I have reviewed the requirements of the provisions of the Cupertino Municipal Code (Chapter 2.100). I certify under penalty of perjury under the laws of the State of California that I have reviewed the Notice of Termination and to the best of my knowledge the information contained herein is true and complete. Termination Effective: ___________ City of Cupertino Lobbyist Registration & Reporting Page 6 of 8 Print Name Title Signature Executed on: (month, day, year) ATTACHMENTS I have reviewed the lobbyist guidelines and I have nothing to report. Attached to this Report is/are the following: _________________________________________________________________________ (If additional space is needed, attach additional pages with responses to each of the above disclosure categories) FEES DUE (CMC 2.100.080 and see Fee Schedule A – General) Lobbyist Registration Fee* (January 1 - December 31) $ Delinquent Fee $ Total Payment Due With Report $ ZĞŐŝƐƚƌĂƚŝŽŶ&ĞĞ ĞůŝŶƋƵĞŶƚ&ĞĞƐ $1ϴϴ͘Ϯϳ $25 per day with a max of $500 DĂŬĞĐŚĞĐŬƐƉĂǇĂďůĞƚŽ͗City of Cupertino ^ĞŶĚ&ŽƌŵƐĂŶĚWĂǇŵĞŶƚƚŽ͗ City of Cupertino City Clerk’s Office 10300 Torre Avenue Cupertino, CA 95014 NOTE: Late fees will apply to any lobbying activity not reported after the 15 days of qualifying as a lobbyist *Initial registration fee is due within 15 days after qualifying as a lobbyist VERIFICATION I certify that I have been authorized by the Lobbyist identified above to make this verification. I have reviewed the requirements of the provisions of the Cupertino Municipal Code (Chapter 2.100). I certify under penalty of perjury under the laws of the State of California that I have reviewed this Lobbyist Report and to the best of my knowledge the information contained herein is true and complete. (CMC 2.100.090(1)) Print Name Title Telephone Number City of Cupertino Lobbyist Registration & Reporting Page 7 of 8 Signature Executed on: (month, day, year) APPENDIX A: Cupertino Municipal Code Ch. 2.100. City of Cupertino Lobbyist Registration & Reporting Page 8 of 8 E-Filed 09/06/2022 14:38:47 Filing ID: 204596225