NSD-2 Webform Supplemental Statement

Supplemental Registration Statement of Individuals (Foreign Agents)

Webform_OMB_1124_0002_Supplemental_Statement_May_2020

Supplemental Registration Statement of Individuals (Foreign Agents)

OMB: 1124-0002

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OMB No. 1124-0002; Expires June 30, 2023

U.S. Department of Justice
Washington, DC 20530

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

INSTRUCTION SHEET-READ CAREFULLY
1.

Use. All persons registered under this Act shall use this form in submitting supplemental statements required by Section 2(b).
Upon termination of the agency which required registration, a final statement shall be filed on this form for the final period of the
agency not covered by the previous statements, as required by Rule 205.

2.

Read Act and Rules. Registrant should carefully read the Act and the Rules thereunder before completing this form.

3.

Answer. Unless otherwise specifically instructed in this form, a registrant shall answer every item on this form. Whenever the
item is inapplicable or the appropriate response to an item is "none", an express statement to that effect shall be made.

4.

Incorporation by Reference. This statement shall be complete in and of itself. Incorporation of information by reference to
statements previously filed is not permissible.

5.

Filing. The completed statement, including all exhibits, shall be filed in electronic form with the FARA Unit, Counterintelligence
and Export Control Section, National Security Division, U.S. Department of Justice at https://www.fara.gov. The statement
must be filed in accordance with 28 U.S.C. § 1746. A copy should be retained by the registrant.

6.

Filing Fee. The filing of this document requires the payment of a filing fee for each listed foreign principal as set forth in Rule
5(d)(1), 28 C.F.R. § 5.5(d)(1).

7.

Filing Date. This statement must be filed within 30 days after the expiration of the six-month reporting period. This period of
time may be extended, for good cause shown, upon written application by the registrant prior to the expiration of the 30 day
period.

8.

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. Provision of the information requested
is mandatory, and failure to provide the information is subject to the penalty and enforcement provisions established in Section 8
of the Act. Every registration statement, short form 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 examination, inspection and copying during the posted business hours of the FARA Unit in Washington, DC. Statements
are also available online at the FARA Unit’s webpage: https://www.fara.gov. One copy of every such document, other than
informational materials, is automatically provided to the Secretary of State pursuant to Section 6(b) of the Act, and copies of any
and all documents are routinely made available to other agencies, 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 available to the public in print and
online at: https://www.fara.gov.

9.

Public Reporting Burden. Public reporting burden for this collection of information is estimated to average 1.17 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 this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden to Chief, FARA Unit, Counterintelligence
and Export Control Section, National Security Division, U.S. Department of Justice, Washington, DC 20530; and to the Office of
Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.
__________
Note: Omit this instruction sheet when filing this Statement.

FORM NSD-2
Revised 05/20

OMB No. 1124-0002; Expires June 30, 2023

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

U.S. Department of Justice
Washington, DC 20530

For 6 Month Period Ending ________________
(Insert date)

I - REGISTRANT
1. (a) Name of Registrant

(b) Registration Number

(c) Primary Business Address

2. Has there been a change in the information previously furnished in connection with the following?
(a) If an individual:
No
(1) Residence address(es)
Yes
(2) Citizenship
Yes
No
(3) Occupation
Yes
No

□
□
□

(b) If an organization:
(1) Name
(2) Ownership or control
(3) Branch offices

Yes
Yes
Yes

□
□
□

□
□
□

No
No
No

□
□
□

(c) Explain fully all changes, if any, indicated in Items (a) and (b) above.

IF THE REGISTRANT IS AN INDIVIDUAL, OMIT RESPONSES TO ITEMS 3, 4, 5, AND 6.
3. If the registrant previously filed an Exhibit C 1, state whether any changes therein have occurred during this 6 month reporting
Yes
No
period.

□

□

If yes, has the registrant filed an updated Exhibit C?

Yes

□

No

□

If no, please file the updated Exhibit C.

1 The Exhibit C, for which no printed form is provided, consists of a true copy of the charter, articles of incorporation, association, and by laws of a registrant that is an
organization. (A waiver of the requirement to file an Exhibit C may be obtained for good cause upon written application to the Assistant Attorney General, National Security
Division, U.S. Department of Justice, Washington, DC 20530.)

FORM NSD-2
Revised 05/20

(PAGE 2)

4. (a) Have any persons become partners, officers, directors or similar officials during this 6 month reporting period?

Yes

□

No

□

If yes, furnish the following information:
Residence Address
Name

Citizenship

Position

Date Assumed

(b) Have any persons ceased acting as partners, officers, directors or similar officials of the registrant during this 6 month reporting period?
Yes
No
If yes, furnish the following information:
Name
Position
Date Ceased

□

□

5. (a) Has any person named in Item 4(a) rendered services directly in furtherance of the interests of any foreign principal?
No
Yes
If yes, identify each such person and describe the service rendered.
Name
Services
Foreign Principal(s) Represented

□

□

(b) During this 6 month reporting period, has the registrant hired as employees or in any other capacity, any persons who rendered
or will render services to the registrant directly in furtherance of the interests of any foreign principal(s) in other than a clerical or
No
secretarial, or in a related or similar capacity?
Yes

□

Name

Residence Address

□

Citizenship

Position

Date Assumed

(c) Have any employees or individuals, who have filed a short form registration statement, terminated their employment or
No
connection with the registrant during this 6 month reporting period? Yes
If yes, furnish the following information:

□

Name

Position or Connection

□

Date Terminated

(d) Have any employees or individuals, who have filed a short form registration statement, terminated their connection with any foreign
No
principal during this 6 month reporting period? Yes

□

□

If yes, furnish the following information:
Name

Position or Connection

Foreign Principal

Date Terminated

6. Have short form registration statements been previously filed by all of the persons named in Items 5(a) and 5(b) of the supplemental
statement or submitted with this filing?
Yes
No

□

□

If no, list names of persons who have not previously filed the required statement or are not submitting a short form with this filing.

(PAGE 3)

II - FOREIGN PRINCIPAL
7. Has the registrant's connection with any foreign principal(s) ended during this 6 month reporting period?
Yes

□

No

□

If yes, furnish the following information:
Date of Termination

Foreign Principal

2

8. Has the registrant acquired any new foreign principal(s) during this 6 month reporting period?
Yes
No

□

□

If yes, furnish the following information:
Date Acquired

Foreign Principal

9. In addition to those named in Items 7 and 8, if any, list the foreign principal(s) whom the registrant continued to represent
during the 6 month reporting period.

10. (a) Has the registrant filed Exhibits A and B for the newly acquired foreign principal(s), if any, listed in Item 8?
N/A
Yes
No
Exhibit A3
4
Exhibit B
Yes
No
N/A

□
□

□
□

□
□

If no, please file the required exhibit.
(b) Have there been any changes in the Exhibits A and B previously filed for any foreign principal(s) whom the registrant
represented during this 6 month period?
Yes
No
If yes, has the registrant filed an amendment to these exhibits?
Yes
No

□
□

□
□

If no, please file the required amendment.
2 The term "foreign principal" includes, in addition to those defined in Section 1(b) of the Act, an individual organization any of whose activities are directly or indirectly
supervised, directed, controlled, financed, or subsidized in whole or in major part by a foreign government, foreign political party, foreign organization or foreign individual.
(See Rule 100(a) (9)). A registrant who represents more than one foreign principal is required to list in the statements he files under the Act only those principals for whom he
is not entitled to claim exemption under Section 3 of the Act. (See Rule 208.)
3 The Exhibit A, which is filed on Form NSD-3, sets forth the information required to be disclosed concerning each foreign principal.
4 The Exhibit B, which is filed on Form NSD-4, sets forth the information concerning the agreement or understanding between the registrant and the foreign principal.

(PAGE 4)

III - ACTIVITIES
11. During this 6 month reporting period, has the registrant engaged in any activities for or rendered any services to any foreign
principal named in Items 7, 8, or 9 of this statement?
Yes
No

□

□

If yes, identify each foreign principal and describe in full detail all activities and services:
Foreign Principal

Activities/Services

12. During this 6 month reporting period, has the registrant, on behalf of any foreign principal, engaged in political activity 5
Yes
No
as defined below?

□

□

If yes, identify each foreign principal and describe in full detail all such political activity, indicating, among other things,
the relations, interests and policies sought to be influenced and the means employed to achieve this purpose. If the registrant
arranged, sponsored or delivered speeches, lectures, social media, internet postings, or media broadcasts, give details as to dates,
places of delivery, names of speakers and subject matter. The response must include, but not be limited to, activities involving
lobbying, promotion, perception management, public relations, economic development, and preparation and dissemination of
informational materials.
Set forth below a general description of the registrant's political activities.

Set forth below in the required detail the registrant's political activities.
Foreign Principal

Date

Contact

Method

Purpose

13. In addition to the above described activities, if any, has the registrant engaged in activity or rendered any services on its own
behalf which benefits the registrant's foreign principal(s)?
Yes
No

□

□

If yes, describe fully.
Foreign Principal

Activities/Services

5 "Political activity," as defined in Section 1(o) of the Act, means any activity that 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 section of the public within the United States with reference to formulating, adopting or changing the domestic
or foreign policies of the United States or with reference to political or public interests, policies, or relations of a government of a foreign country or a foreign political party.

(PAGE 5)

IV - FINANCIAL INFORMATION
14. (a) RECEIPTS-MONIES
During this 6 month reporting period, has the registrant received from any foreign principal named in Items 7, 8, or 9 of this
statement, or from any other source, for or in the interests of any such foreign principal, any contributions, income or
money either as compensation or otherwise?
Yes
No

□

□

If no, please explain why no monies were received.

If yes, set forth below in the required detail and separately for each foreign principal an account of such monies.6
Foreign Principal

Purpose

Date Received From Whom

Amount

Subtotal

______________
Total
(b) RECEIPTS - FUNDRAISING CAMPAIGN
During this 6 month reporting period, has the registrant received, as part of a fundraising campaign7, any money on behalf
of any foreign principal named in Items 7, 8, or 9 of this statement?
8

If yes, has the registrant previously filed an Exhibit D to its registration?
If yes, indicate the date the Exhibit D was filed.

□
Yes □
Yes

□
No □
No

Date ____________________

If no, please file the required Exhibit D.
(c) RECEIPTS-THINGS OF VALUE
During this 6 month reporting period, has the registraint received any thing of value9 other than money from any
foreign principal named in Items 7, 8, or 9 of this statement, or from any other source, for or in the interests of any such
foreign principal?
No
Yes

□

□

If yes, furnish the following information:
Foreign Principal

Date Received

From Whom

Purpose

Thing of Value

6, 7 A registrant is required to file an Exhibit D if he/she collects or receives contributions, loans, moneys, or other things of value for a foreign principal, as part of a fundraising
campaign. (See Rule 201(e)).
8 An Exhibit D, for which no printed form is provided, sets forth an account of money collected or received as a result of a fundraising campaign and transmitted for a foreign
principal.
9 Things of value include but are not limited to gifts, interest free loans, expense free travel, favored stock purchases, exclusive rights, favored treatment over competitors,
"kickbacks," and the like.

(PAGE 6)

15. (a) DISBURSEMENTS-MONIES
During this 6 month reporting period, has the registrant disbursed or expended monies in connection with activity on
behalf of any foreign principal named in Items 7, 8, or 9 of this statement or transmitted monies to any such foreign
No
principal?
Yes

□

□

If no, explain why no disbursements were made.

If yes, set forth below in the required detail and separately for each foreign principal an account of such monies, including
monies transmitted, if any, to each foreign principal.
Foreign Principal

Date

Recipient

Purpose

Amount

Subtotal

_______________
Total

(PAGE 7)

(b) DISBURSEMENTS-THINGS OF VALUE
During this 6 month reporting period, has the registrant disposed of anything of value 10 other than money in furtherance
of or in connection with activities on behalf of any foreign principal named in Items 7, 8, or 9 of this statement?
No
Yes

□

□

If yes, furnish the following information:
Foreign Principal

Date

Recipient

Purpose

Thing of Value

(c) DISBURSEMENTS-POLITICAL CONTRIBUTIONS
During this 6 month reporting period, has the registrant (or any short form registrant) from its own funds and on its own
behalf either directly or through any other person, made any contributions of money or other things of value 11 in connection
with an election to any political office, or in connection with any primary election, convention, or caucus held to select
candidates for political office?
Yes

□

No

□

If yes, furnish the following information:
Date

Donor

Political Organization/Candidate Method

Amount/Thing of Value

10, 11 Things of value include but are not limited to gifts, interest free loans, expense free travel, favored stock purchases, exclusive rights, favored treatment over competitors,
"kickbacks," and the like.

(PAGE 8)

V - INFORMATIONAL MATERIALS
16. (a)

(b)

During this 6 month reporting period, has the registrant prepared, disseminated or caused to be disseminated any
12
informational materials?
Yes
No

□

□

If yes, identify each such foreign principal(s) for which informational materials were disseminated.

17. During this 6 month reporting period, has a budget been established or specified sum of money allocated to finance the
registrant's activities in preparing or disseminating informational materials?
Yes
No
If yes, identify each such foreign principal, and specify the period of time and the amount.
Foreign Principal

□

□

Period of Time

Amount

18. During this 6 month reporting period, has the registrant's activities in preparing, disseminating or causing the dissemination of
informational materials include the use of any of the following:
Press releases
Pamphlets or other publications
Magazine or newspaper
Advertising campaigns
Lectures or speeches
Radio or TV broadcasts
Motion picture films
Letters or telegrams
Email
Website URL(s): _______________________________________________________________________________________
Social media websites URL(s): ____________________________________________________________________________
Other (specify) ________________________________________________________________________________________

□
□
□
□
□
□

□
□

□
□

□
□

19. During this 6 month reporting period, has the registrant prepared, disseminated, or caused to be disseminated informational
materials among any of the following groups:

□ Public officials
□ Newspapers
□ Legislators
□ Editors
□ Government agencies
□ Civic groups or associations
□ Other (specify)________________________________________

□ Libraries
□ Educational institutions
□ Nationality groups

20. Indicate the language used in the informational materials:

□ Other (specify) _______________________________________

□ English

21. Has the registrant filed with the FARA Unit, U.S. Department of Justice a copy of each item of such informational materials
prepared, disseminated or caused to be disseminated during this 6 month reporting period?
Yes
No

□

□

If no, please please file the required informational materials.
22. Has the registrant labeled each item of such informational materials with the statement required by Section 4(b) of the Act?
Yes

□

No

□

12 The term informational materials includes any oral, visual, graphic, written, or pictorial information or matter of any kind, including that published by means of advertising,
books, periodicals, newspapers, lectures, broadcasts, motion pictures, or any means or instrumentality of interstate or foreign commerce or otherwise. Informational materials
disseminated by an agent of a foreign principal as part of an activity in itself exempt from registration, or an activity which by itself would not require registration, need not be
filed pursuant to Section 4(b) of the Act.

(PAGE 9)

VI - EXECUTION
In accordance with 28 U.S.C. § 1746, and subject to the penalties of 18 U.S.C. § 1001 and 22 U.S.C. § 618, the undersigned swears or
affirms under penalty of perjury that he/she has read the information set forth in this Supplemental Statement, 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.
Date

Printed Name

Signature 13
Sign

Sign
Sign

Sign

13 This statement shall be signed by the individual agent, if the registrant is an individual, or by a majority of those partners, officers, directors or persons performing similar
functions, if the registrant is an organization, except that the organization can, by power of attorney, authorize one or more individuals to execute this statement on its behalf.


File Typeapplication/pdf
SubjectVersion 1.3
AuthorAMUDD
File Modified2020-05-12
File Created2019-06-20

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