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Get OR Lobbying Registration Statement 2009-2024

1. Lobbyist Information: (See instructions. Enter address where the quarterly expenditure report should be sent.) Mailing Address: City, State, Zip: Contact Person: Tele: (business) (fax) (e-mail) Name of any member of the Oregon Legislative Assembly employed, retained, or otherwise compensated by the lobbyist: 2. Lobbyist Verification: I CERTIFY UNDER PENALTY OF FALSE AFFIRMATION THAT THE REGISTRATION INFORMATION IS TRUE AND CORRECT. Name: Signature: Date: Name: Signature: Date: Nam.

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