Lobbyist Termination Request Form Lobbyist Termination Request Form Email* Confirm Email Name Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Suffix Entity Name*Entity Email* Lobbyist Registration Number*I, as Registrant, declare, affirm and represent that I have authority to terminate the registration referenced above. I also declare that I have not conducted, nor will conduct, any lobbying activity on behalf of the entity listed above after the last date of the quarter for which my latest quarterly lobbyist report was submitted. If I wish to conduct any lobbying activity on behalf of the entity listed above in the future, I understand that I must complete a new registration.I agree to the above statement
