VA Lobbyist Principal Signature Waiver Form, 2016 June 23

Online content

Fullscreen
PRINCIPAL SIGNATURE WAIVER FORM

Per § § 22-423, a principal authorizing officer may elect to waive the principal signature
on disclosure filings submitted by its regi d lobbyist.

q'

If you are a principal and would like to waive your signature requirement, you must submit a
waiver form to Council staff.

Please use one form for each lobbyist who represents you.

Please return the completed form to:

Virginia Conflict of Interest and Ethics Advisory Council
Attn: Michelle LeGates
201 N. 9" St. 2" Floor
Richmond, VA 23219
Phone (804) 786-3591
Fax (804) 371-8705
miegates@dls.virginia.gov

Date: \ i Ze, VELA

Name of PRINCIPAL: Vi an 5 ae Abort TES te Ve Suet} fently

(Print)

Name of Principal Officer: * Aehael E, Baie

(Print)

Name of Lobbyist: Vi Wg me ae

U (Print)

As principal, I hereby waive the signature requirement on the lobbyist disclosure statement for
the above-referenced lobbyist.

oe”
Principal Officer: Zz pa Z Ai

(Signature)


Metadata

Resource Type:
Document
Rights:
Image for license or rights statement.
CC BY-NC-SA 4.0
Date Uploaded:
January 3, 2026

Using these materials

Access:
The archives are open to the public and anyone is welcome to visit and view the collections.
Collection restrictions:
Access to this collection is unrestricted with the exception of select items noted in Series 5.
Collection terms of access:
This page may contain links to digital objects. Access to these images and the technical capacity to download them does not imply permission for re-use. Digital objects may be used freely for personal reference use, referred to, or linked to from other web sites. Researchers do not have permission to publish or disseminate material from these collections without permission from an archivist and/or the copyright holder. The researcher assumes full responsibility for conforming to the laws of copyright. Some materials in these collections may be protected by the U.S. Copyright Law (Title 17, U.S.C.) and/or by the copyright or neighboring-rights laws of other nations. More information about U.S. Copyright is provided by the Copyright Office. Additionally, re-use may be restricted by terms of University Libraries gift or purchase agreements, donor restrictions, privacy and publicity rights, licensing and trademarks. The Department of Special Collections and Archives is eager to hear from any copyright owners who are not properly identified so that appropriate information may be provided in the future.

Access options

Ask an Archivist

Ask a question or schedule an individualized meeting to discuss archival materials and potential research needs.

Schedule a Visit

Archival materials can be viewed in-person in our reading room. We recommend making an appointment to ensure materials are available when you arrive.