2019_Q2;FSB_PUBLIC_AFFAIRS_INC;AMANTE,JERRYCity of Anaheim
Office of the City Clerk
Please submit completed form(s) to:
Mail or In person: Office of the City Clerk
200 S. Anaheim Blvd. Ste. 217, Anaheim, CA 92805; or
Email: tbass@anaheim.net; or Fax: (714) 765-4105
LOBBYIST'S QUARTERLY REPORT OF ACTIVITY
CHECK APPLICABLE REPORTING PERIOD: •Ql: Due April 30 (January 1-March 31) DQ3: Due October 31 (July 1 -September 30) 2019
j ✓ I Q2: Due July 31 (April 1 -June 30) DQ4: Due January 31 (October 1 -December 31)
Year ____ _
LOBBYIST INFORMATION
NAME OF LOBBYlsr (Last, F,Tst, M.1.)
Amante, Jeny
BUSINESS EMAIL
jam ante@fsbcorestrategies.com
BUSINESS ADDRESS
2099 S. State College Blvd., Suite 630
REPORTING SCHEDULES
[{] No Lobbying Activity
I did not participate or engage in any
form of !obbying during the reporting
period.
Verification
NAME OF LOBBYING FIRM (if applicable)
FSB Public Affairs, Inc.
CITY
Anaheim
CHECK All APPLICABLE
BUSINESS PHONE (XXX) XXX-XXXX
(949) 336-4500
STATE ztp CODE
CA 92806
• Lobbying Activity/ D Campaign Contribution Report
Client Disclosure Report
Schedule A: Report any form of Schedule B: Report any contributions
lobbying by the !obbyir:g firm/ lobbyist made during the reporting period to
of the City of Anaheim or any regional the Mayor or any City Council Member
agency in which Anaheim has a voting by the lobbying firm/lobbyist.
role during this reporting period.
I certify that I have reviewed Ordinance No. 6417, made available on the City of Anaheim's website and reviewed
all applicable lobbying provisions. I declare under penalty of perjury under the laws of the State of California that
the i erein is true and accurate to the best of my knowledge.
Lobbyist's Quarterly Report of Activity Rev 06/19
PRINT NAME OF LOBBYlsr
Amante, Jerry
DATE (mm/dd/yyyy)
09/13/2019
Page_!__ of 2_
By City of Anaheim - Office of the City Clerk at 3:04 pm, Sep 13, 2019
City of Anahe i m
Amante, Jerry Name: ________________ _
Office of the Gty Clerk
SCHEDULE A-CLIENT DISCLOSURE
CHECK APPLICABLE REPORTING PERIOD:
DQ1: Due April 30 (January 1-March 31) DQ3: Due October 31 (July 1 -September 30)
l ✓IQ2: Due July 31 (April 1-June 30) DQ4: Due January 31 (October 1-December 31)
2019 Year ____ _
Note: Complete this form for each client in which five hundred dollars ($500) or more was received in a calendar month.
CLIENT INFORMATION
NAMEOFCUENT(Last, First, M.I.)
Kanne, Larry
BUSINESS ADDRESS
14218 Aliso Ct.
CLIENT DISCLOSURE
BUSINESS NAME
A2D Sports, LLC
CITY
Chino Hills
I
Total Compensation Lobbyist $
. Received from Oient:
BUSINESS PHONE (XXX) XXX-XXXX
(562) 754-7237
STATE ZIP CODE
CA 91709
Desaibe the local leglslattve or administrative actlon{s} that the lobbying firm/lobbyist supported or opposed during tfle reporting period.
None during this period
Dlsdose any form of communication by the lobbyins firm/lobbyist during the reporting period. Use a separate entry for each
newrontact.
1. DATE OF CONTACT NAME & TITLE OF CITY OFFICIAL OR STAFF CONTACTED NAME OF LOBBYIST
DESCRIBE PURPOSE OF MEETING:
2. DATE OF CONTACT NAME & TITLE OF CITY OFFICIAL OR STAFF CONTACTED NAME OF LOBBYIST
DESCRIBE PURPOSE OF MEETING:
3. DATE OF CONTACT NAME & TITLE OF CITY OFFICIAL OR STAFF CONTACTED NAME OF LOBBYIST
DESCRIBE PURPOSE OF MEETING:
4. DATE OF CONTACT NAME & TITLE OF CITY OFFICIAL OR STAFF COl'ITACTED NAME OF LOBBYIST
DESCRIBE PURPOSE OF MEETING:
D If more space Is needed check box and attach additional pages.
Schedule A -Client Disclosure (Rev 06/19) Page 2-_ of ~
Amante, Jerry Name: ________________ _
SCHEDULE B-CAMPAIGN CONTRIBUTIONS
CHECK APPLICABLE REPORTING PERIOD: D Q1: Due April 30 (January 1 -March 31) D Q3: Due October 31 (July 1 -September 30) 2019
J ✓ j Q2: Due July 31 (April 1 • June 30) D Q4: Due January 31 (October 1 -December 31)
Year ____ _
Note: This form is to report campaign contributions made to any member of the City Council by the lobbying
firm/lobbyist during the reporting period.
CAMPAIGN CONTRIBUTIONS
Disclose all campaign contnbutions by the lobbyi ng firm/lobbyist during the reporting period,
DATE AMOUNT NAME OF CONTRIBUTION RECIPIENT NAME OF LOBBYIST
1.
2.
3 .
. ...
5.
6.
7.
8.
9.
10. NONE
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Schedule B -Campaign Contributions Rev. 06/19 Page 2._ of __2__