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2018_Q4;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 STEVEN GREYSHOCK GREYCOMM, LLC STEVE@GREY-COMM.COM 714-330-0321 27702 CROWN VALLEY PKWY D-4 334 LADERA RANCH CA 92694 STEVEN GREYSHOCK GREYCOMM LLC 1/31/2019 4 4 4 RECEIVED: 02/02/19 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. 12/21 $250 HARRY SIDHU STEVE GREYSHOCK 12/4 $500 JORDAN BRANDMAN STEVE GREYSHOCK 4