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2019_Q3;GREYCOMM_LLC;GREYSHOCK,STEVEN City 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: Q1: Due April 30 (January 1 - March 31) Q3: Due October 31 (July 1 - September 30) Q2: Due July 31 (April 1 - June 30) Q4: Due January 31 (October 1 - December 31) Lobbyist’s Quarterly Report of Activity (REV 09/13/2017) Page ____ of ____ PART I – LOBBYIST INFORMATION NAME OF LOBBYIST (Last, First, M.I.) NAME OF LOBBYING FIRM (if applicable) BUSINESS EMAIL BUSINESS PHONE (XXX) XXX-XXXX BUSINESS ADDRESS CITY STATE ZIP CODE PART II – REPORTING SCHEDULES Note: Check all applicable. No Lobbying Activity Lobbying Activity/Client Disclosure Report Campaign Contribution Report I did not participate or engage in any form of lobbying during the reporting period. Schedule C: Report any form of lobbying by the lobbying firm/ lobbyist of the City of Anaheim or any regional agency in which Anaheim has a voting role during this reporting period. (Attach Schedule C) Schedule D: Report any contributions made during the reporting period to the Mayor or any City Council Member by the lobbying firm/lobbyist. (Attach Schedule D) Verification 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 information contained herein is true and accurate to the best of my knowledge. SIGNATURE OF LOBBYIST PRINT NAME OF LOBBYIST NAME OF LOBBYING FIRM (if applicable) DATE Greyshock, Steven M GREYCOMM, LLC steve@grey-comm.com (714) 658-6299 1600 DOVE ST NEWPORT BEACH CA 92660 Steven Greyshock GREYCOMM, LLC 4 4 4 11/19/2019 RECEIVED: November 19, 2019 BY: City of Anaheim - Office of the City Clerk City of Anaheim Office of the City Clerk (Firm) Name: _________________________________________ CLIENT DISCLOSURE – SCHEDULE C CHECK APPLICABLE REPORTING PERIOD: Q1: Due April 30 (January 1 - March 31) Q3: Due October 31 (July 1 - September 30) Q2: Due July 31 (April 1 - June 30) Q4: Due January 31 (October 1 - December 31) Note: Complete this form for each client in which five hundred dollars ($500) or more was received in a calendar month. This form may be duplicated for additional entries. Client Disclosure – Schedule C (REV 09/11/2017) Page ____ of ____ PART I – CLIENT INFORMATION Total Compensation Lobbyist Received from Client: $ NAME OF CLIENT (Last, First, M.I.) BUSINESS NAME BUSINESS PHONE (XXX) XXX-XXXX BUSINESS ADDRESS CITY STATE ZIP CODE PART II – CLIENT DISCLOSURE SECTION A. Describe the local legislative or administrative action(s) that the lobbying firm/lobbyist supported or opposed during the reporting period. SECTION B. Disclose any form of communication by the lobbying firm/lobbyist during the reporting period. Use a separate entry for each new contact. 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 CONTACTED NAME OF LOBBYIST DESCRIBE PURPOSE OF MEETING: If more space is needed for Part II, Section B. – Client Disclosure, check box and attach additional pages. GREYCOMM, LLC 16,500.00 KIM, ROBERT 6509 SERRANO LP (714) 658-6299 1600 DOVE ST NEWPORT BEACH CA 92660 Land use considerations 9/26/2019 Councilmember Moreno Steve Greyshock Project update and briefing 9/4/2019 Councilmember Faessel Steve Greyshock Project update and briefing 9/13/2019 Councilmember Barnes Steve Greyshock Project update and briefing 4 City of Anaheim Office of the City Clerk (Firm) Name: _________________________________________ CAMPAIGN CONTRIBUTIONS – SCHEDULE D CHECK APPLICABLE REPORTING PERIOD: Q1: Due April 30 (January 1 - March 31) Q3: Due October 31 (July 1 - September 30) Q2: Due July 31 (April 1 - June 30) Q4: Due January 31 (October 1 - December 31) Note: This form is to report campaign contributions made to the Mayor or any City Council Member by the lobbying firm/lobbyist during the reporting period. This form may be duplicated for additional entries. Campaign Contribution – Schedule D (REV 09/11/2017) Page ____ of ____ PART I – CAMPAIGN CONTRIBUTIONS Disclose all campaign contributions by the lobbying firm/lobbyist during the reporting period. DATE AMOUNT NAME OF CONTRIBUTION RECIPIENT NAME OF LOBBYIST 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. If more space is needed for Part I – Campaign Contributions, check box and attach additional pages. GREYCOMM, LLC 8/7/2019 $500 Lucille Kring for Supervisor Steve Greyshock 4