Form OBD 1124-0006 OBD 1124-0006 Exhibit A to Registration Statement

Exhibit A to Registration Statement (Foreign Agents)

OMB_1124_0006 (7)

Exhibit A to Registration Statement (Foreign Agents)

OMB: 1124-0006

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Exhibit A

U.S. Department of Justice
Washington, DC 20530

OMB NO. 1124-0006

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

Privacy Act Statement. The filing of this document is required by 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 this 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 Registration Unit in Washington, DC. Statements
are also available online at the Registration Unit's webpage: http://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: http://www.fara.gov/.
Public Reporting Burden. Public reporting burden for this 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 this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Chief,
Registration Unit, Counterespionage 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.
Furnish this exhibit for EACH foreign principal listed in an initial statement
and for EACH additional foreign principal acquired subsequently.

1. Name and address of registrant

2. Registration No.

3. Name of foreign principal

4. Principal address of foreign principal

5. Indicate whether your foreign principal is one of the following:
Foreign government

Foreign political party
Foreign or domestic organization: If either, check one of the following:
Partnership

Committee

Corporation

Voluntary group

Association

Other (specify):

Individual-State nationality

6. If the foreign principal is a foreign government, state:
a) Branch or agency represented by the registrant
b) Name and title of official with whom registrant deals

7. If the foreign principal is a foreign political party, state:
a) Principal address
b) Name and title of official with whom registrant deals

c) Principal aim
Formerly CRM-157

FORM NSD-3

DECEMBER 2007

8. If 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 principal

Yes

No

Owned by a foreign government, foreign political party, or other foreign principal

Yes

No

Directed by a foreign government, foreign political party, or other foreign principal

Yes

No

Controlled by a foreign government, foreign political party, or other foreign principal

Yes

No

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 fully all items answered "Yes" in Item 8(b).

(If additional space is needed, a full insert page must be used.)

10. If the foreign principal is an organization and is not owned or controlled by a foreign government, foreign political party or other foreign
principal, state who owns and controls it.

Date of Exhibit A

Name and Title

Signature


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