LD-1 Disclosure Form

Clerk of the House of Representatives
Legislative Resource Center
135 Cannon Building
Washington, DC 20515
http://lobbyingdisclosure.house.gov

Secretary of the Senate
Office of Public Records
232 Hart Building
Washington, DC 20510
http://www.senate.gov/lobby

LOBBYING REGISTRATION

Lobbying Disclosure Act of 1995 (Section 4)

Check One: New Registrant New Client for Existing Registrant Amendment

			1. Effective Date of Registration		10/1/2019
2. House Identification	44541			Senate Identification	401105403

REGISTRANT Organization/Lobbying Firm Self Employed Individual

3. Registrant

Organization

Keurig Dr Pepper Inc.

Address

5301 Legacy Drive

Address2

City

Plano

State

Zip

75024

Country

USA

4. Principal place of business (if different than line 3)

City

State

Zip

Country

5. Contact name and telephone number

International Number

Contact

Mr. Randall Downing

Telephone

9726737684

E-mail

randall.downing@kdrp.com

6. General description of registrant’s business or activities

Beverage Company

CLIENT A Lobbying Firm is required to file a separate registration for each client. Organizations employing in-house lobbyists should check the box labeled “Self” and proceed to line 10. Self

7. Client name	Keurig Dr Pepper Inc.
Address

City

State

Zip

Country

USA

8. Principal place of business (if different than line 7)

City

State

Zip

Country

9. General description of client’s business or activities

LOBBYISTS

10. Name of each individual who has acted or is expected to act as a lobbyist for the client identified on line 7. If any person listed in this section has served as a “covered executive branch official” or “covered legislative branch official” within twenty years of first acting as a lobbyist for the client, state the executive and/or legislative position(s) in which the person served.

Name			Covered Official Position (if applicable)
First	Last	Suffix
Randall	Downing
Kelly	Smith
Gina	Mordeaux

LOBBYING ISSUES

11. General lobbying issue areas (Select all applicable codes).

AGR

BEV

CSP

FOO

HCR

TAX

TRD

12. Specific lobbying issues (current and anticipated)

H.R. 1406 - APEX Act; promotes transparency in aluminum market pricing H.R. 1374 - Drive Safe Act; directs the Department of Transportation to promulgate regulations to implement an apprenticeship program for licensed commercial motor vehicle drivers under the age of 21. S. 1982/H.R. 3969 - Save our Seas 2.0; deals with packaging and recycling H.R. 3705 - Sweet Act; issues related to the federal sugar subsidy program; Smart Snacks in Schools regulations Food Stamp regulations Food Safety regulations Nutrition facts panel and other labeling regulations Ingredient regulations Consumer products/appliance energy efficiency standards Recycling regulations Refrigerant regulations

AFFILIATED ORGANIZATIONS

13. Is there an entity other than the client that contributes more than $5,000 to the lobbying activities of the registrant in a quarterly period and either participates in and/or in whole or in major part supervises or controls the registrant’s lobbying activities?

No --> Go to line 14.

Yes --> Complete the rest of this section for each entity matching the criteria above, then proceed to line 14.

Internet Address:

Name

Address

Principal Place of Business

Street

City

State/Province

Zip Code

Country

City

State

Country

City

State

Country

City

State

Country

FOREIGN ENTITIES

14. Is there any foreign entity

a) holds at least 20% equitable ownership in the client or any organization identified on line 13; or

b) directly or indirectly, in whole or in major part, plans, supervises, controls, directs, finances or subsidizes activities of the client or any organization identified on line 13; or

c) is an affiliate of the client or any organization identified on line 13 and has a direct interest in the outcome of the lobbying activity?

No --> Sign and date the registration.

Yes --> Complete the rest of this section for each entity matching the criteria above, then sign the registration.

Address

Ownership

Name

Street

Principal place of business

Amount of contribution

City

State/Province

Country

(city and state or country)

for lobbying activities

Oosterdoksstraat 80

City

Amsterdam

JAB Holdings B.V.

Amsterdam

NED

State

Country

NED

0.00

Oosterdoksstraat 80

City

Amsterdam

Maple Holdings B.V.

Amsterdam

NED

State

Country

NED

0.00

CONVICTIONS DISCLOSURE

15. Have any of the lobbyists listed on this report been convicted in a Federal or State Court of an offense involving bribery, extortion, embezzlement, an illegal kickback, tax evasion, fraud, a conflict of interest, making a false statement, perjury, or money laundering?
No Yes

Signature

Digitally Signed By: Randall Downing

Date

10/28/2019 1:14:00 PM

ADDITIONAL LOBBYISTS

10. Supplemental. List any additional lobbyists for this client not listed on page 1, number 10.

Name			Covered Official Position (if applicable)	Have you been convicted of a crime?
First	Last	Suffix

ADDITIONAL LOBBYING ISSUES
11. Supplemental. General lobbying issue areas. Enter any additional codes for issues not listed on page 2, number 11.

ADDITIONAL AFFILIATED ORGANIZATIONS13. Supplemental. List any other affiliated organization that meets the criteria specified and is not listed on page 2, number 13.

Name

Address

Principal Place of Business

Street

City

State/Province

Zip Code

Country

City

State

Country

City

State

Country

City

State

Country

ADDITIONAL FOREIGN ENTITIES
14. Supplemental. List any other foreign entity that meets the criteria specified and is not listed on page 2, number 14.

Name

Address

Principal place of business
(city and state or country)

Amount of contribution for lobbying activities

Ownership

Street
City	State/Province	Country

Acorn Holdings

Oosterdoksstraat 80
Amsterdam		NED

City	Amsterdam
State		Country	NED

0.00

67 %

City
State		Country

City
State		Country