Transcript
Page 1: Far Av Zla Regis Tro Fitzgibbon

8/21/2019 Far Av Zla Regis Tro Fitzgibbon

http://slidepdf.com/reader/full/far-av-zla-regis-tro-fitzgibbon 1/7

Received by NSD/FARA RegiaMtim]^ AM

u.s. Department

 of justice

  Exhibit

 A to Registration Statement

Washington pc

 20530  Pursuant

 to the Foreign

 Agents

 Registration Act o

1938, as amended

INSTRUCTIONS. Furnish this exhibit for

 EACH

 foreign principal listed in an initial statement and for

 EACH

 additional

 foreign principal acquired

subsequently.

 The fil ing of this document, requires die payment of a filing fee as set

 forth

 in Rule (dXl) , 28 CF.R. § 5.5(d)(1). Compliance is

accompfehed by

 filing an

 eleetrntuc'Exhibit A

 form

 at

 )frflrx//www,fara.gov.

Privacy

 Act

 Statement The filing of this document is required

 by

 me Foreign Agents Registration

 Act

 of 1938,, as amended, 22

 U.S.G.

 § 611 etseq.,

for

 the

 purposes

 of registration

 under

 the

 Ac t

 and public disclosure. Provision of the information requested s mandatory, and failure to provide this

information is subject to the penalty arid enforcement provisions established  in Section

 8

 o f the

 Act.

  Everyregistration

 statement,

 short

  form

registration

  statement,

 supplemental

 statement, exhibit, amendment,

 copy

 of inforrnational

 materials or other document or

 mformation filed with

 the

Attorney General

 irn rthis

 Actis a

 public

 iroord open to inspection and

 copying

 during the posted busing*

 hours

 ofthe

Registration

 Unit tn

 Washington, Dt .

  Statements

 are also available online at the Registration

 Unit's

 webpage: http://www-fara.goy. One copy o f

every such document, other than

 informational

 materials, is automatically provided to the

 Secretary o f State pursuant

 to Section 6(b) of the

 Act,

 and

copies o f any and

 all

 documents areroutinely made available to outer agencies, departments and Congress

 pursuant

 to Section

 6(c)

 of the Act the

Attorney General also: transmits a senri'-amiual report to Congress on me adtairjjstratron ofthe

 Act

 which lists the names o f all agents registered

 unde

the

 Ac t

 and theforeign principals they

 represent.

 This report is available to the public in print and online at:htip://vmw.fip-a,gov.

Public Reporting Burden. Public reporting burden

 for

 mis collection of information is estimated to

 average

 .49

 hours

 per

 response,

 including the

time

 for reviewing

 instructions, searching existing

 data sources,

 gathering and maintaining the

 data needed,

 and completing and

 reviewing

 the

collection of information. Send

 comments

 regarding

 his burden

 estimate

 or

 any

 other aspect

 of

 this

 collection of information, including suggestions

for reducing his burden to Chief, Registration

 Unit,

 Counterespionage Section,

 National

 Security

 Division,

 U.S. Department of Justice, Washington,

DC 20530; and to foe Office o f Information and Regulatory A

 ffairs,

 Office o f Management and Budget, Washington, DC 20503.

1. Name and Address  o f Registrant

FitzGibbon M e d i a j n c ^

2. Registration No.

3  Name'of Foreign Principal

Embassy of the  Bolivarian Republic of Venezuela

4.

  Principal Address  o f Foreign Principal

1099 30th Street IMW

Washington, DC  20007

5. Indicate whether your

 foreign principal

 is one

  o f

 the

 fo l low ing :

S Government

  o f

 a

 foreign

 country

1

  Foreign

 political

 parry

•  Foreign or domestic organization:

  f

 either, check one o fthe fo l low ing :

  Partnership • Committee

Q Corporation • Voluntary group

• Association  •  Other (specify)

  Individual-State nationality

6.  f the foreign principal is a foreign government,

 state:

a) Branch or agency represents

Embassy

 of

 the Bolivarian

 Republic of

 Venezuela

 in

 the

 U5.

b)  Name and

  title

  o f o f f i c i a l w i th whom registrant

 deals

Maximi l len

 Arvaiaiz, Charge

 t Affairs

7.

  f

 the foreign principal is a foreign political party,

 state:

a) Principal address

b)  Name and

  title

  o f o f f i c i a l w i th whom registrant

 deals

c)

  Principal aim

1

  Governmentof.a

 foreign country,-'

 as defined

 in

 Section

 1(e) of

 the

 Act

 includes any person

 or group of persons exercising

 sovereign

 de facto or

 de jure

 political jurisd

over

 any country, other than die

 United

 States, or over

 any

 part

 of

 such country,

 and includes any

 subdivision

 of any such

 group

 and any

 group or

 agency

 to which

 such

 sov

facto

 or de jure authority or functions are directly or indirectly delegated. Such erm shall include any

 faction

 or

 body

 of insurgents

  within

 a country assuming to

 exercis

governmental, authority

 whether such faction

 or body

 of

 insurgents has

 cir

 has not

 been

 recognized bv the

 United

 S

 ates.

FORM

 NSD-3

Received by

 NSD/FARA

 Registration

 Unit

 06/15/2015

 9:46:45 A M  R sedos/w

Page 2: Far Av Zla Regis Tro Fitzgibbon

8/21/2019 Far Av Zla Regis Tro Fitzgibbon

http://slidepdf.com/reader/full/far-av-zla-regis-tro-fitzgibbon 2/7

Received

 by NSD/FARA Registration

 Unit

 06/15/2015 9:46:45 A M

8.

  f

 the

 foreign principal is not a foreign

 government

 or a foreign political party:

a)  State the

 nature

 of the business or

 activity

 of this foreign principal.

b)  Is this foreign principal:

Supervised by a foreign

 government,

 foreign political party, or other foreign

 prm

  YesD

  No •

Owned by a

 foreign

 government,

 foreign political party, or

 other

 foreign

 principal  Yes • No •

Directed1 by

 a  oreign government,

 foreign political

 pa Yes • No •

Controlledby a

 foreign

 government,

 foreign ootitical party, or

 ofoer

 foreign principal  YesD

  No D

Financed by a foreign government, foreign political party, or other foreign principal  Yes

 • No •

Subsidized in part

 by

 a foreign government, foreign political party,

 or

 other

 foreign

 principal

  Yes • No •

9

Explain.

 illy

 ali items aaswenscl Yes Item o^b).. (Ifadditionalspace is needed

 a

 ull insert page must be used)

10.  f

 the

 foreign

 principal

 is

 an organization and

 is

 not owned

 or

 controlled by a foreign government, foreign political party or othe

foreign principal, state

 who

 owns and

 controls

 it.

EXECUTION

In accordance with

 28

 U.S.C.

 §

 1746, the

 undesigned sweats

 oi-

 affirms under

 penalty o f perjury that he/she has

 read

 foe

mformation

 set

 forth n this

 Exhibit

 A

 to

 the registration stitfement and that he/she is

 familiar

 with the

 contents foerebf

 and that su

contents

 are in

 meir entirety

 true

 and accurate to

 the

 best of his/her

 knowledge

 and belief.

Da^dfEpiibitA'

June

 12,2015

Name and Title

Alexander

 B. Thomson,

 Senior Vice

 President

Signature

/s/ Alexander

 B. Thomson

eSigned

Received

 by NSD/FARA Registration

 Unit 06/15/2015

 9:46:45

 A M

Page 3: Far Av Zla Regis Tro Fitzgibbon

8/21/2019 Far Av Zla Regis Tro Fitzgibbon

http://slidepdf.com/reader/full/far-av-zla-regis-tro-fitzgibbon 3/7

Received

 by NSD/FARA R e g i m ^ % ^ m ^ ^ , M ^ AM

ir.s. Department

 of Justice

  Exhibit B to

 Registration

 Statement

Washington

 D 20530  Pursuant to the Foreign Agents

 Registration

 Act o

1938, as amended

INSTRUCTIONS.

  A

 registrant must furnish,

 as

 an Exhibit

 B

 copies

 of

 each

 written

 agreement

 and the

 erms

 and conditions of

 each oral agreement

with his oreign prmcipal, including

 all

 modifications

 of such agreements,

 or,

 where no

 contract

 exists,

 a full statement

 of all the

 circumstances by

reason of

 which the

 registrantsacting

 as an

 agent of a

 foreign principal.

 Compliance

 is

 accomplished

 by

 filing

 an

 electronic Exhibit B form at

http;//vy>ywiara,gov.

Privacy

 Act

 Statement.

  The

 filing

 of

 this

 document

 is required

 for

 the Foreign

 Agents

 Registration

 Act

 of 1938, as

 amended,22

 U.S.G.

 § 611

 ets'eq

for

 the purposes

 of registration

 under

 the

 Act

 and public

 disclosure.

 Provision

 of

 the

 information requested

 is

 mandatory,

 and

 failure

 to

 provide

themformation is

 subject

 o.the penalty

 and enforcement provisions

 established

 m

 Section

 8 o f the Act.  Every

 reg stratipnstatement,

 short

  form

registration  statement, supplemental statement,

 exhibit, amendment,

 copy of

 informatibnal

 materials

 or

 other document

 or information

 filed wit

Attorney

 General meter this Act is a public

 record

 open to

 public

 examination,

 inspection

 and copying during the posted business

 hours of the

Registration

 Unit

 in Washington, DC.

  Statements

 are

 also available

 online

 at

 foe

 Registration

 Unit's

 webpage:  hj^^Ayyjr^j^a^Qy..

 One copy of

every

 such document, other

 than informational materials, is

 automatically

 provided to the Secretary

 of

 State pursuant

 to

 Section 6(b)

 of

 die

 Act, and

copies

 of any

 and

 ali

 documents

 are

 routinely

 made available

 to

 other agencies, departments

 and

 Congress

 pursuant to

 Section6(c) offoe

 Act The

Attorney

 General: also tjsmsmits,.a semi-annual report to Congress on

 the adMoistration

 of

 the

 Act

 which lists, the

 names of

 aJJ

 agents registered und

the

 Act

 and tlw

 oreign rmodpals t   represent This report

 is

 available to

 the

 public

 in

 print

 and

 online

 at

  fet^;//<yw\y.fara.goy.

Public Reporting Burden: Public

 reporting

 burden for

 his

 collection

 of information is estimated

 to

 average

 .33

 hours

 per

 response, including

 the

time  for reviewing

 nstructions, searching

 existing data sources, gathering and

 maintatmng

 the data

 needed,

 and completing and

 reviewing

 he

collection

 of

 mformation. Send comments regarding

 his burden

 estimate or any

 other

 aspect

 of this

 collection

 of

 information,

 includingsuggestion

for

  reducing

 this burden

 to

 Chief,' Registration Unit, Counterespionage Section,National

 Security

 Division, U.S. Department of Justice, Washingt

DC 20530;

 and

 to theOffice of

 mformation and

 Regulatory Affairs,

 Office

 of

 Management

 and

 Budget,

 Washington,

 DC 20503.

1.. Name o f Registrant

FitzGibbon Media, Inc.

2.

  Registration

 No.

3 .

 Name o f Foreign

 Principal

Embassy of the

 Bolivarian

 Republic

 of Venezuela

Check Appropriate

 Box:

4. _\

  The agreement

 betweenfoe

 registrant and the

 above-named foreign principal

 is

 a formal written

 contract.  f this box

 is

checked, attach a

 copy

 of

 foe contract

 to

 this

 exhibit.

5.

 •

  There is no

 formal written contract

 between the

 registrant

 and the

 foreign principal.

  The

 agreement with

 the

 above-named

foreign

 principal has

 resulted from an exchange of correspondence.  I f this box is checked, , attach a copy of alii pertinent

correspondence, including a copy of any

 initial proposal

 which

 has

 been adopted by reference

 in

 stwh-con«sp<mdeiiq

6.

 •

  The

 agreement

 or undeirsfonding between the

 registrant

 and the

 foreign

 principal is

 the

 result

 of

 neither

 aformal written

contract nor an exchange o f correspondence between the parties.  f this box is checked,

 give

 a complete description below

 of

the terms

 arid

 conditions

 o f the

 oral

 agreement or

 ifoderstwding, its duration,

 the foes and expenses,

  i f

 any,

 to

 be received

7. Describe fully the

 nature

 and

 method

 of performance of the

 above

 indicated agreement or understanding.

Registrant will provide

 public

 relations

 strategy

 and media relations services to the Embassy ofthe

 Bolivarian

 Republic of

Venezuela per the

 terms

 of the

 attached contract

Received by NSD/FARA Registration Unit 06/15/2015 9:46:45 A M

FORM

 NSD-4

Revised 03/14

Page 4: Far Av Zla Regis Tro Fitzgibbon

8/21/2019 Far Av Zla Regis Tro Fitzgibbon

http://slidepdf.com/reader/full/far-av-zla-regis-tro-fitzgibbon 4/7

Received

 by NSD/FARA Registration

 Unit

 06/15/2015 9:46:45

 A M

8. Describe

 fully trie-activities

 the

 registrant

 engages

 in

 or proposes to

 engage in

 on

 behalf

 of the above foreign principal.

Registrant

 will provide publicrelatiom strategy and

 media relations

 services to the Embassy

 of

 the Bolivarian

 Republic of

Venezuela per the terms ofthe attached

 contract.

9. Wilfthe

 activities on behalf

 of

 foe

 above foreign prmcipal'include political

 activities

 as defined

 in Section i(o)

 ofthe

 Act

 and in

foe

 footnote

 below?  Yes • No S

f

 yes,

 describe

 all

 such

 political

 activities indicating, among other things, the

 relations,

 interests

 or policies

 to

 be influenced

together  with the means to be employed to achieve

 ins

 purpose.

EXECUTION

In

 accordance

 with

 28

 U.S.C.

 §

 1746, the

 undersigned

 swears

 or affirms

 under penalty

 of

 perjury

 that

 he/she

 has

 read

 the

mformation

 set forth n

 this Exhibit B to foe

 registration

 statement and

 that he/she

 is familiar

 with foe

 contents

 thereof and that

 such

contents

 are

 in

 meir entireh/ true

 and

 accurate

 to

 the

 best of his/her knowledge

 and

 belief.

Date

 of

 Exhibit

 B

June 12,2015

Name and

 Title

Alexander

 B. Thomson,

 Senior Vice

 President

Signature

fs/

 Alexander

 B. Thomson

eSigned

Footnote:

  Political activity, asdefined in Section l(o) of he Act, means any activity which the person engaging in believes will ,or

 that

 the person intends

 o

n any way influenc

any agency or offioial

 of he

 Government

 of the

 United States or any section

 of

 the public

 within the

 United States with

 reference

 to

 trmoiating, adopting,

 or changing the

domestic or oreign policies of ite United States or with referenced  country or a foreign political

party.

  . . . -

Received by NSD/FARA Registration Unit 06/15/2015 9:46:45 A M

Page 5: Far Av Zla Regis Tro Fitzgibbon

8/21/2019 Far Av Zla Regis Tro Fitzgibbon

http://slidepdf.com/reader/full/far-av-zla-regis-tro-fitzgibbon 5/7

Fitz©i|?bori^M  Inc.

MJV22.2015

Ole nff behalf without

will perform these scrrt

A .

wt th the

lentconfir

1 0

1 3

a t t r r v t imov ou f

4-

to

. .V r

e a d io f

1

5

  ^ - y ^ - ' - '

4'   i

ft;

4 - :

Received

 by

 NSD/FARA Registration

 Unit 06/15/2015

 9:46:45 AM

Page 6: Far Av Zla Regis Tro Fitzgibbon

8/21/2019 Far Av Zla Regis Tro Fitzgibbon

http://slidepdf.com/reader/full/far-av-zla-regis-tro-fitzgibbon 6/7

;GJierf* agrees

directors cancers

the

ofa

from

or

from

mm

behaffof

prior

 approval.

and

 hold

o

from

of

o f

Neither cartv shaft

.

2

re

O f

out of

A t

pursuant**

thbAjr^rrmm,

I ts

or

¥?wfe i i t e f

 .shi

e r

mm

of

o f

T P *

1

* *

 the

to

A*

m

ttw entire

 agrMrrwmt

o f * *

ati

Prtbr

-4s

A ;

A ,  - J . - .  .

I

  J

Received

 by

 NSD/FARA

 Registration Unit

 06/15/2015 9:46:45

 AM

Page 7: Far Av Zla Regis Tro Fitzgibbon

8/21/2019 Far Av Zla Regis Tro Fitzgibbon

http://slidepdf.com/reader/full/far-av-zla-regis-tro-fitzgibbon 7/7

services

this

or no reason.

notice

 to

*uch notfe©-

dateof

 temnrutjan

agreed upon by both

 parties.

e

Client

MM

ams

3 to

'jpriotf prior «• ft*

on a

This

be Swarned by tho

WiimrfCflfcari***,

aw tows of

•or

to the

ffthls

We took forward to

Agreed

/ i i i£

•5:

3  • -V** .-,v

• .v,, .-,:-^. . 1

X T

•-•£:J


Recommended