USS. House of Representatives MEMBERI/OFFICER TRAVEL DISCLOSURE FORM This form is for disclosing the receipt of travel expenses from private sources for meetings, speaking engagements, fact-finding tips or similar events in connection with official duties, You need not disclose government-funded or political travel on this form, or travel that is unrelated to official duties. This form does not eliminate the need to report all privately-funded travel on the annual Financial Disclosure Statements, | In accordance with House Rule 51, please complete this form and file it with the Clerk of the House of Representatives, B-106 Cannon House Office Building, within 30 days after travel is completed. The Clerk shall make these forms available to the public as soon as possible after they are filed, Description of the trip: DATES OF TRAVEL: (20-9090 = _\La3lan00 DESTINATION(S): _Av. ra. , Flori I SPONSOR (WHO PAID FOR THE TRIP):JRK Sool oF GoVERNMOT/THE Comumswem PURPOSE: BAP, N ONAL ! Provide a good faith estimate of the following: LTH TOTAL TRANSPORTATION EXPENSES: 40 Ss é ‘TOTAL LODGING EXPENSES: Lae =, 82 a mS TOTAL MEAL EXPENSES: Fe se B 5. | aa TOTAL OF ALL OTHER EXPENSES: Yor Be _ Ss 1 #2 B38 | = 3 Thave determined that all of the expenses listed above were necessary and that the Havel Qas 5 in connection with my duties as a Member/Officer of the House of Representatives and srould not = create the appearance that I am using public office for private gain, Name: Rick A. LAZIO | (please print or type) - SIGNATURE: 0 bate A1Y/200d