Commission on Ethics and Lobbying Notice of Appearance Form | New York State Commission on Ethics and Lobbying in Government

Commission on Ethics and Lobbying Notice of Appearance Form

This form must be completed by every person or entity appearing before the Commission on Ethics and Lobbying Notice of Appearance Form (the “Commission”) on behalf of itself or another individual
or entity in a representative capacity in any enforcement, investigatory, or similar matter before
the Commission, other than if such individual or entity is appearing solely in its capacity as a
“lobbyist” or “client” as those terms are defined in Article 1-A of the Legislative Law and related
regulations. This form shall be filed with the Commission before or upon such appearance.

Commission Case Number

1. Name of Firm/Individual Appearing

Address

City/Town

State

ZIP/Postal Code

Telephone

Email

2. Client represented

Address

City/Town

State

ZIP/Postal Code

Telephone

Acting in the capacity of

Attorney

Agent

Other (describe)

I, , appear for the Client listed in paragraph 2 in the above referenced proceeding.

Dated:

Name of Attorney or Agent

Signature

Sign above