Lobbying Registration
Maryland State Ethics Commission | 45 Calvert Street, 3rd Floor, Annapolis, Maryland 21401
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Form ID: R010339
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Submission Date: 11/01/22
Registrant Information
| Individual Registrant | |
|---|---|
| Name of Registrant: Daniel Shattuck | Business Phone: 410-269-1503 |
| Organization: Brocato & Shattuck | Cell Phone: 410-375-1690 |
| Address: 200 Duke of Gloucester St., Annapolis, MD, 21401 | |
1. Are there any other individuals who are required to register on behalf of the registrant:
Daniel Shattuck?
Note: These individuals will still be required to submit their own registrations.
Note: These individuals will still be required to submit their own registrations.
No
2. Are you in compliance with the mandatory training requirements of the Public Ethics Law?
Yes, I certify that I am current in my training status.
Date of most recent training:
09/27/21
Employer Information
1. Identify the employer that compensates the registrant for lobbying activities under this registration.
| Employer of Registrant | |
|---|---|
| Organization: American Physical Therapy Association Maryland - APTA MD | Website: www.aptamd.org |
| Nature of Business: Professional association of physical therapists and physical therapist assistants | Phone: 800-306-5596 |
| Address: 18919 Surreywood, San Antonio, TX, 78258 | |
2. Does your employer claim an exemption from filing its own registration and activity reports?
Yes
3. Is the employer organized for the primary purpose of attempting to influence any legislation or executive action?
No
4. In the course of representing this employer, will you also be representing other entities from which you will not be receiving compensation and are not required to register on their behalf?
No
Lobbying Period & Purpose
1. Within a lobbying year, state the period for which this registration is effective. Include both a start and an end date.
Registration Period:
Entire Lobbying Year: 11/1/2022-10/31/2023
2. What type of lobbying registration are you seeking?
Legislative Action, Executive Action, Grassroots
3. Identify the subject matters on which the registrant expects to act, or employ someone to act during the registration period. You must identify at least one subject matter and you may select up to five.
| # | Subject Matter | Description |
|---|---|---|
| 1 | Insurance - Health | |
| 2 | Health Occupations | |
| 3 | Health Care Facilities and Regulation | |
| 4 | Public Health |
Authorization to Lobby
The registrant is authorized to act on behalf of the employer identified above, for the period specified and as to the matters selected herein unless this authority is terminated sooner. This authorization has been granted by the representative disclosed below:
Name of Authorizer: Lauri Jacobson
Title: Executive Director
Email: [email protected]
Phone: 800-306-5596
Address: 24218 Viento Leaf, San Antonio, TX, 78260
Affirmation Provision
I solemnly affirm under the penalties of perjury that the contents of this document are true to the best of my knowledge, information and belief. I am authorized to engage in lobbying activity on behalf of the employer: American Physical Therapy Association Maryland - APTA MD, for the period specified and as to the matters selected herein, unless this authority is terminated sooner. This authorization has been granted to me by the representative: Lauri Jacobson. I acknowledge that my electronic signature subjects me to the penalties of perjury to the same extent as an oath or affirmation made before an individual authorized to administer oaths, and swear that the contents of this registration are complete and accurate to the best of my knowledge and belief.
E-signature: Daniel Shattuck