Skip to main content

Exhibit B to Registration Statement Pursuant to the Foreign Agents Registration Act of 1938, as amended

OMB NO. 1124-0004; Expires February 28, 2014
U.S. Department of Justice Exhibit B to Registration Statement
Washington, DC 20530 Pursuant to the Foreign Agents Registration Act of
1938, as amended
INSTRUCTIONS. A registrant must furnish as an Exhibit B copies of each
written agreement and the terms and conditions of each oral agreement
with his foreign principal, including all modifications of such agreemen
ts, or, where no contract exists, a full statement of all the circumstan
ces by
reason of which the registrant is acting as an agent of a foreign princi
pal. Compliance is accomplished by filing an electronic Exhibit B form
at
http://www.fara.gov.
Privacy Act Statement. The filing of this document is required for the
Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. § 611
et seq.,
for the purposes of registration under the Act and public disclosure. P
rovision of the information requested is mandatory, and failure to provi
de
the information is subject to the penalty and enforcement provisions est
ablished in Section 8 of the Act. Every registration statement, short f
orm
registration statement, supplemental statement, exhibit, amendment, copy
of informational materials or other document or information filed with
the
Attorney General under this Act is a public record open to public examin
ation, inspection and copying during the posted business hours of the
Registration Unit in Washington, DC. Statements are also available onli
ne at the Registration Unit’s webpage:
http://www.fara.gov . One copy of
every such document, other than informational materials, is automaticall
y provided to the Secretary of State pursuant to Section 6(b) of the A
ct, and
copies of any and all documents are routinely made available to other ag
encies, departments and Congress pursuant to Section 6(c) of the Act.
The
Attorney General also transmits a semi-annual report to Congress on the
administration of the Act which lists the names of all agents registered
under
the Act and the foreign principals they represent. This report is avail
able to the public in print and online at:
http://www.fara.gov .
Public Reporting Burden. Public reporting burden for this collection of
information is estimated to average .33 hours per response, including t
he
time for reviewing instructions, searching existing data sources, gather
ing and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding this burden estimate
or any other aspect of this collection of information, including sugges
tions
for reducing this burden to Chief, Registration Unit, Counterespionage S
ection, National Security Division, U.S. Department of Justice, Washingt
on,
DC 20530; and to the Office of Information and Regulatory Affairs, Offic
e of Management and Budget, Washington, DC 20503.
1. Name of Registrant 2. Registration No.
3. Name of Foreign Principal
Check Appropriate Box:
4. □ The agreement between the registrant and the above-named foreign prin
cipal is a formal written contract. If this box is
checked, attach a copy of the contract to this exhibit.
5.
□ There is no formal written contract between the registrant and the fo
reign principal. The agreement with the above-named foreign principal has resulted from an exchange of correspondence. If t
his box is checked, attach a copy of all pertinent
correspondence, including a copy of any initial proposal which has been
adopted by reference in such correspondence.
6.
□ The agreement or understanding between the registrant and the foreign
principal is the result of neither a formal written contract nor an exchange of correspondence between the parties. If this
box is checked, give a complete description below of
the terms and conditions of the oral agreement or understanding, its dur
ation, the fees and expenses, if any, to be received.
7. Describe fully the nature and method of performance of the above ind
icated agreement or understanding.
Formerly CRM-155
Revised 03/11
FORM NSD-4

8. Describe fully the activities the registrant engages in or proposes
to engage in on behalf of the above foreign principal.
9. Will the activities on behalf of the above foreign principal include
political activities as defined in Section 1(o) of the Act and in the footnote below? Yes
□ No □
If yes, describe all such political activities indicating, among ot
her things, the relations, interests or policies to be influenced together with the means to be employed to achieve this purpose.
EXECUTION
Footnote: Political activity as defined in Section 1(o) of the Act mea
ns any activity which the person engaging in believes will, or that the
person intends to, in any way influence
any agency or official of the Government of the United States or any sec
tion of the public within the United States with reference to formulatin
g, adopting, or changing the
domestic or foreign policies of the United States or with reference to t
he political or public interests, policies, or relations of a government
of a foreign country or a foreign political
party.
Date of Exhibit B Name and Title Signature
In accordance with 28 U.S.C. § 1746, the undersigned swears or affirm
s under penalty of perjury that he/she has read the
information set forth in this Exhibit B to the registration statement an
d that he/she is familiar with the contents thereof and that such
contents are in their entirety true and accurate to the best of his/her
knowledge and belief.

-->