CHICAGO PARK DISTRICT
541 N. Fairbanks Court
Chicago, Illinois 60611
Phone: 312-742-4602 Fax: 312-742-5316
NOTE: Pursuant to Section F of Chapter III of Chicago Park District’s Code, information you provide shall be
made available to the public, which may include posting by the Park District on the Internet.
LOBBYIST TERMINATION NOTICE
I have terminated all activities that require registration as a lobbyist with the Chicago Park District.
Included with this notice is a final activity report covering the period between the most recently filed activity
report and the date of termination. The effective date of termination is: __________________________________.
This notice, when filed, relieves me of further reporting requirements under Chapter 2-156, Article III of the
Municipal Code of Chicago, until and unless I again undertake activities requiring registration.
Name of Lobbyist/Registrant:______________________________________________
Signature of Lobbyist/Registrant
Signed and sworn or affirmed before me this ____________ day of _________________________, 20_________