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Type of lobbyist:    Need help?

I am registering as a(n)*  

       Individual lobbyist that is not employed by a lobbying firm (enter the individual's name below)
       Individual lobbyist employed by a lobbying firm (enter the individual's name and the firm name below)
       Single-member lobbying firm (enter the individual's name and the firm name below)
       Lobbying firm with 2 or more members (enter the firm name below)
       State lobbyist (liaison) working on behalf of a Colorado state agency (enter the individual's name below)
       Entities reporting contributions and expenditures only (enter the organization name below)


Individual's name:
(Last) (First) (Middle) (Suffix)

Firm / Organization name:


Business Address

Address1: *
Address2:
City: *
State: *
Zip: *
Province:
Country: *
Phone:   Ext:     Fax:
Email: *



Agent Information
If you are filing disclosure statements on behalf of the lobbyist, enter your information below
Name:
*
(Last) (First) (Middle) (Suffix)
 
Business Address
Address1: *  
Address2:
City: *
State: *
Zip: *
Province:
Country: *
Phone:   Ext:     Fax:
Email: *