|
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)
| 1. Effective Date of Registration | 2/15/2023 |
||||
| 2. House Identification | 39128 |
Senate Identification | 313271 |
||
REGISTRANT Organization/Lobbying Firm Self Employed Individual
| 3. Registrant | Organization | Subject Matter |
||||
| Address | 1201 NY Ave. NW |
Address2 | Suite 900 |
| City | Washington |
State | DC |
Zip | 20005 |
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. Steven Elmendorf |
Telephone | 2028984797 |
LDA@teamsubjectmatter.com |
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 | Polygon Labs Services (Switzerland) AG |
| Address | Baarerstrasse 98 |
| City | Zug |
State |
|
Zip | 6300 |
Country | SUI |
| City |
|
State |
|
Zip |
|
Country |
|
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 |
|
| Stacey | Alexander | | Chief of Staff - Rep. Jim Matheson |
| Barry | LaSala | | Counsel - Senate Small Business Committee (Sen. John Kerry) |
| James | Ryan | | General Counsel - Sen. Harry Reid |
| Rebecca | Shaw | | Chief of Staff - Rep. Trey Hollingsworth; Deputy Chief of Staff & Legislative Director, Legislative Director, Sr. Legislative Assistant, Legislative Assistant - Rep. Chris Gibson; Intern - Rep. Devin Nunes |
| Natalie | Farr | | COS, Dep. COS - Sen. Cory Gardner; COS, Dep. COS/Leg. Dir., Leg. Dir. - Rep. Cory Gardner; Prof. Staff - H. Rep. Study Cmte (Rep. Tom Price); LA - DOL: LA- Rep. John Shadegg; Projects Asst -Rep. Policy Cmte (Sen. Jon Kyl) |
LOBBYING ISSUES
11. General lobbying issue areas (Select all applicable codes).
BAN |
FIN |
SCI |
TAX |
|
|
|
|
|
12. Specific lobbying issues (current and anticipated)
Issues related to Web3 technology; issues related to privacy
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 | ||||||||||
|
||||||||||
Polygon Labs Services (Delaware) Inc. |
8605 Santa Monica Blvd, PMB 42857 |
|
||||||||
|
|
|||||||||
|
|
|
||||||||
|
|
|||||||||
|
|
|
||||||||
|
|
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 and state or country) | for lobbying activities | ||||
4th Fl Harbour Pl, 103 S Church St, POB 10240 |
|
|||||||||||
Polygon Labs Holdings (Cayman) Ltd. |
|
|
0 |
100 |
% | |||||||
4th Fl Harbour Pl, 103 S Church St, POB 10240 |
|
|||||||||||
Mihailo Bjelic (through holdings in Polygon Labs Holdings (Cayman) Ltd. |
|
|
0 |
22.76 |
% |
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?
| Signature | Digitally Signed By: Steven Elmendorf |
Date | 6/26/2023 6:04:24 PM |
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 |
||
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
|
|
|
|
|
|
|
|
|
| Name | Address | Principal Place of Business | ||||||||
| Street | ||||||||||
|
||||||||||
|
|
|
||||||||
|
|
|||||||||
|
|
|
||||||||
|
|
|||||||||
|
|
|
||||||||
|
|
| Name | Address |
Principal place of business (city and state or country) |
Amount of contribution for lobbying activities | Ownership | ||||||||||||||
| ||||||||||||||||||
Polygon Foundation (through holdings in Polygon Labs Holdings (Cayman) Ltd) |
|
|
0 |
77.24 % |
||||||||||||||
Sandeep Nailwal (Polygon Foundation director) |
|
|
0 |
0 % |
||||||||||||||
Antoni Martin Beltran (Polygon Foundation director) |
|
|
0 |
0 % |
||||||||||||||
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 |
||
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
|
|
|
|
|
|
|
|
|
| Name | Address | Principal Place of Business | ||||||||
| Street | ||||||||||
|
||||||||||
|
|
|
||||||||
|
|
|||||||||
|
|
|
||||||||
|
|
|||||||||
|
|
|
||||||||
|
|
| Name | Address |
Principal place of business (city and state or country) |
Amount of contribution for lobbying activities | Ownership | ||||||||||||||
| ||||||||||||||||||
Jordi Baylina (Polygon Foundation director) |
|
|
0 |
0 % |
||||||||||||||
Sanket Shah (Polygon Foundation director) |
|
|
0 |
0 % |
||||||||||||||
Polygon Labs Tokens (Caymen) Ltd. |
|
|
30000 |
0 % |
||||||||||||||