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City Lobbying Information Form Instructions

Please fill out the Lobbying Information Form and submit it by email, fax or campus mail to Governmental Relations in a timely manner for each quarterly reporting period.

In completing the Lobbying Information Form, please keep in mind the following parameters:

  • Notify the University's Governmental Relations Office of all contacts with the City of Pittsburgh, on behalf of the University (contact Paul Supowitz 624-2901 or psupowit@pitt.edu).
  • Return your completed form via the web or by fax (624-7707) to Governmental Relations on or before the 5th of the month (i.e., January 5, April 5, July 5 and October 5).
  • List any expenses incurred on behalf of City elected or other officials and City employees (such as meals, hospitality or tickets). Please understand that there are very few exceptions to the prohibition on providing gifts of any kind to city officials and employees.  If you have questions about city matters, please contact Paul Supowitz at 421.624.290l or psupowit@pitt.edu.

    To assist us in complying with these requirements, please complete the reporting form, it can be completed and submitted online at: http://www.govtrel.pitt.edu/city/lobbyinfocity.html or you may print it out, complete it, and fax it to 412.624.7707

If you have any questions regarding the City Lobbying Information Form, please contact Paul Supowitz in Governmental Relations (624-2901) or psupowit@pitt.edu.

City Lobbying Information Form

For the three month period of (check one):

Jan - Mar
Apr - Jun
July - Sept
Oct - Dec

I. BACKGROUND

Your Name

Department & Position

Campus Address

Campus Phone

E-mail Address


No Activity or expenses this quarter

II. City Lobbying and Expenses

Please list any expenses incurred on behalf of City elected or other officials and City employees (such as meals, hospitality or tickets).

Date

Name of city official/employee

Type and description of expense, i.e., gift, meal, reception, etc., and reason for expense

Total Cost

 

Date

Name of city official/employee

Type and description of expense, i.e., gift, meal, reception, etc., and reason for expense

Total Cost


Date

Name of city official/employee

Type and description of expense, i.e., gift, meal, reception, etc., and reason for expense

Total Cost


Date

Name of city official/employee

Type and description of expense, i.e., gift, meal, reception, etc., and reason for expense

Total Cost

 

Date

Name of city official/employee

Type and description of expense, i.e., gift, meal, reception, etc., and reason for expense

Total Cost

 

 

 

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