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Received by NSD/F ARA Registration Unit 02/28/20 I 7 I 0:42:4 7 AM

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Suµplcmenlal Statement u.s. Oq;i.-n,u.-11 r .. r .111>1i<~

\Viu.J,i ri~HT~. nc "?n5-1{t Pursuant to ihc f"ort\ign A~ents Rcgistnttion Ac1 of 1938, as amended

{,;:) ll>J,irum~ /\1m!ri:i~(c~} of!~,:,-jj.1~1-;-;r,1.

O.r4> um"' Strffl London fOM7rlA

Fnr Sis M,:ct111 il\;riod l:.1>:.linL:!1 January :.HHl:i (~M\'.\\•i~•t

I • REGISTRANT

1, Hai ckotc btcsn a d1Mge in ihc i,ifonn;,ri,:tt1 fHCVim{'.ily flm1i,hcd fr; <)Onoc.:1im1 with lite fo!!,nvfat!l:

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IF THE REGISTRM<i"T JS AN lNDJVJDUAt.., OMIT RESPONSE TO rn:.MS 3, -4, AND .S(a},

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If tut, 1il!l'at.e ;tl(;1d1 th,: tt:qtml!ll! 1m1.:hclmi:t1t.

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lfyi;-~. fm·n:i~h Hx IoHrs,•.'l'ti,¥, iiul~nrn..::1:1.,1~:

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Se-an Mc.Gov?m

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lfye:., ii:lemify ead,·;,11<·h ,i-:,,w,1 _,,,d ,k:,i,:li!w !ht n,n·kc rn1J<:'trd.

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Se,m MtGcwem Chief Rlw: Offk:er & Gt11,~rnl Covn:,d

td) l·fov~ ;ioy ,m,pl'l),,-:,s nr indivk:hial~. who no,•;;, filed n sltnrt fr,mi rez~ra1.im1 $\:,temse111, te:mt113led lhdr ,:,;mr..,.,tk,n with '1Jt)' k,;".::ign p!'.iotip,il during dih ,', •>1<.mlil T11pi,,1mg periixt, Y,:,; 0 No IB.! rr ~(%. {tnnish foe n,u,,wi,1µ h,foonati,m,

t<. H;;•,e ~llliltl f,>m:o :r<lffiiilllrll!i<:m .1tut1.,rncn11. b~~ l'ik'<I h:i :ill il.f l'ile pt.T,wm llalllCJ Ji, ll'trrncs S(iJ anli S(b) "J' .[lit: ~til)t1lc111e,111J.l ,talc1tlL'tll~

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11- Hm.EIGN l'IUNCIPAL

·t, H~ yi\tt: \.-it)n1· ici ~i•,,1 w\~h ~u1y fa1-r,~t1.1~ ;vtl11t:i1}.1t •:m.lt1.J thu•ih?J (ht.:. f~, t1lti:l'ith t~T1trnl;)~, p-tr\ .. -i,J· ~ Jryc-,;, tbn11:t.h l!H"; foJh1\J.•;ng 1~1n111na,d1111:

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IQ (a) Hn.,-c ym, f!kd,.,c-bihi~ forthc newly :~qum,,d foreign prindpi.!{s). ff:iny,h5h:.J in £.;.,,n 8'! Exbibi!A1 Yes O 'N;, ®

(];) H,we tih:rnb<!tlJ a,y clli1:1ig1:s iij !he Exhibitz A 1mct H pt>::viows1y fikd for an:i,• fufcign pri11c'ip1d witom you r.:,pt~c'titeJ Jur,ng fuiii six month t'll!riod? YC!i O No ~ lfycs,,ha\•c 'yi:N filed 1110 $1litat<.'mci,t ti) thew <1i,;hibiU'?

ifno, plea,e attach ihe required ~rn~ndmrm.

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j The ~m "'fot~ilfu p-·b11p~ b~~ m sdtfai,:n, t<-:. :r~o~ ozt1td i1: Se<:1len itbf ltf th«: Art. ,m tN.th-t.iud ~:q:infl~o MW/ -of~-~ .wtf-vititw .iN tffuN-Uy or tritf}~d'Y s;;;,;:J'11w:li, l!itcrn!l. ~~lkd, till~ ar i'ttai\JITi;tl~ y,,f~vk rr ~ m1{~ ii1~ 't7;::t ~';il!~ ttJ.Vtt~t rumw, r1nthi~! tmt~i. il•~ rnulmft..1tt,;i:11-01 ~~ hWl'¾!lt~t {~r:lh;it H',Cf,J) \!lkt, A ~itt.nl afoJ .-~~ ~,re Ut'~t1 m~ !~~ j.lltt"~ ill! ~uio::l ~ li:Q fr;;.. Ci~ :i!;..•ltnlnUi h:: Gib, ~f tht A.-.:r fl~' tac~ p(1htfptAt :fht-"\W(UU l;o: i~~i uuitJ:rt ~ dl.lim•!::tcµ-tµl_iM tmJt>r Sr'.!tti'ID $ o-fth: .~d (S@ R¾tk 't«i~)

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JU· ,\CTIVITIES -~-,,_,._.,.,,,""""1".-m..r..,ou-.,,;m ___ '+ ... -•-e,x-•~#~fa~X--------------------------

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1fy¢t, ,&en:.ty•i::i.d, ffeud; fotd,t11 !»'ineipa,l .,rtJ! de..:rihc ill !hi! ,ki:d all ,Ui:J!l ~oli1ical :1.:1ivi1y. k,dicoti,it, ,1mnog othl!'t lhi11gs, 1hc .xb11fons, inkr>.:•,tli ,md polkcicf sought tn be irif1,M11c,e,;l ,md !he 111c:m:; emph:,y;:d i() ;id,k:ve ihh piicr,",;,.;· ff tl,~ rrt/i~!nW1~ i!JNngr.;l, xp611sun:1I ••rdd.iv"'c,;l S('4'~"'-'nc$, k..:f(lit:.s ,,,., radio imd TV i,ium:ka,;t;;, giv.:.1frrnlt, itii t,, dsh:!L vla,-.:~ uf,Miv,-ry, ,wmc~ ,1f ;;pe:ik.:rn and hubjt.'>:ol maitcr.

f'~- refor to (Juestkm 11 ..

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w fott1gti ~;t-'.c:i-t1: Qf fi.s.t: Un~u.d ~t~ i.'~-:° ~"ifh rt!ztct'J<"'l: to ?J{ft¼>~} gq::~hlfr frm:n:~ pHli~'.i::i}~. (.f" ~el#tk~ ,14-:--?': ~1.1W.1'.;11·~;:,,"1t ~-ir a .fomt,1? ~'.tj.!lh}i< m ~ f(1~i~ p,ti)i:1ii:~i1 pi.~1:,<

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RECIHPTS. f'llNDfUISING CAl\fP/IIGN Dmiing lhis 6 mont·h rcpur!in,g p,,r,,:,,l, h;,,,.:. yon n:;xivl'.<l, ~s fMft of 11 fi;n.<!i.;hini ~art,p,iig1l', aity mooey oo l;,~hal f ,,f 11ny f1>r-:ign prindp;1I nw,,..d Jn·lt~ms 7, S.1.119 oflhili ~1,1.lcmem'/ Y,,:;: [l No g/

h:s0 No □

ft} RECEJPTS..:THINGS OF VALUE O.:r!111_1; this 6 nmnt h rupmiiJ;g period, ti.wr yq)J ttceivei.l MY 1liini of'i'nli.ic' MIier than m,:,ncy flx;m ruty fact'.i~n priocipi!l · aamcd in hem$ 7, If, llr '> c,fthfa, Rta1crm:nt, or from uny other so1.m:c, forori:1 tht intcrosts ofonysll!(:}1 fo,~ign pno,ip;,17

Yes O No f8l

Thing of Value

tt~ 1 A .r{~~Ilm b r<\ylirtd ~ t1tr oo tt• ll ·ii: h-: l'.dksft~ ~r ""-'W$, ~u·1tm.;~n~, ¼;~ .. mn~iy\, ,1, ~•hw 1hiht,~ ,~oft41h~ ~ i,i (r,fl'-iiyn ;thfci~,. ~ vw• uf :, (iuMtri:t4l:0,i. <%"1"',it• . !s« Role l!ll(,:J~ ,

'4 Ar.. f,.,'<hihil D~ f.,~·~hith .:ro pr~Q f~#wi-1 _rrtW~;1 ·t:;tt fue'Oi uti at:u;(1m ,.r tmt:try t"a1ktlt:cl ut tci.~\tt--J. i~ n ~ af fi 'ftlfrlk~-t~ rm.J trur~tl!d tr» l ~>r:.gn pri,q!<I.

fJ 'thin~ (l<f '<'.l.,~ i.i~lmk b.l£ at~ fftll Hmlkti hl- SUIL, htRntt fM !rum. <'X~W-iC f~ lf,!¥d,, (,t•N·m.-4. i•t~k f!Wtt~li t'f~lut(%· ~~ ~\••~1:;,W tr·•-.,--:t•~ t?t-tt ,;t;m.\l';tif-«,~ . ~tw,14,' ~m:I <k iw:.

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U :r:,~. :-:e~ f1)rt;h b{½lo•tt..v i¥J th,: i'i:,;pt.it.i!d detiti1 and ><::p,1-rnr,·fy k,r l"'-ad~ !0<n::·ign prlncit12il mt n.=::curn1 or ~nch n1onks., Jncht4ing. ,m,nit0< trati:,miucd, if-a11y, 10 cad1 fon::ii!fel prir1dp0L

A 'l/'lO/'l/\1'7 11\.A"'-"""' _.,. ..

Received by NSD/F ARA Registration Unit 02/28/2017 10:42:4 7 AM

!bl »ISBlll{SEMEN'l'8-Hll"iG5 OF VAUJI', f>v:r~nr: 1his !~ rn.omh rcptu(tnt; p:;-·r~uit bah· r~Ju dii:~.pu~d tJ(m:1y:hing: .,ff v,ei:httw uthct"eh;rn. ou.,rn;;;~t -in funh,;tM~t.:c 1..,!'ur ~fr

c,,nn•.'t·,1,m \:,.\th uc1,,·i1k·, (Hl tx:l·,.,ff of a,1y foir\:ign J)l'tr•,ipal 1111111,:J in hnm 7, iL 01 't ,;,fthis ,t11-:m.;;nC'

Yc-;cL] No ill

Thing. ofV,1foe

(.:} DISBllRSE:Mf..NTS-POUTtCAil. CO!'HRIRUl'IONS D'lu:1,g ,hiis 6 nwmh ,.::puHtnl/, l"'liutl. ha'l-t: yu11 frunt yuu, uwn 1,111,ii;; un<i m1 ycur own oohalf cidt>::r liir1Xtly or th1>1t1g!1 any o,ths:,r prr.;otL ti>a.lk: any ;ontnbut«ler$ of money ,,r- ill htr· lh1ng~ ,,l\·:1b1.:'' in co1111~c1i,1A with m1 eb::1 io:n r,, MY r<,!iiii:.,f ol·fit!'e. {,r in t.'l;M11.zc1ion wt:!1 wny primary d.::ction, 0011Ycmio11, or (atlrn:. held to ~dc,r,t cund'ida1c; frirpo!itir.nl i)ftic,e'?

Ye.~ 0 Nn IZJ

Amount Qif Thing L•fVnlrn:

l{t I 1 Thi~ i)f.~ h"::t»;.\? t,Jt ~ not lin,ifnl to git~ iut~tt f,;~ lmu~ .. c,,~ ft~ ~;i.i., &'Vtm;,J~:dt ltt$<~, C:s.,;l»,fv:- fi~~ f,4\t:ir,e:tJ rfn.m.~ £i',ft:'l".wu111::fit\'<l11

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: ti (~} [)ur.1n;: 1!~~½ {~· ~n_.(lml\ ·r..,..poning Jttriu<l.. ~Ji(! ·:r1JlJ -~;, t1,-1-.1r'-\ iJ1,s-s~11lh;iH.i tr.· riHt~ to be th;'<'!'•~r'llina~t'>sJ >!WY jo(41l)~tit)1l,nJ n·mtc1ia!~ ?n ',',;:~ 0 !'fo ~

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rn. Dui'iug 1h.is i, nxinth r,;pmtrng period, htis a1ry 1,,rd;,in p1111(iµ~I ,t~imbl:igJ,od ;:, &tdticr ,w d i(,.;;~kd " ;;1101::ifiiJ sum of nh:i1icy w

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l f y,;:.,, idc~1!il"r i!M;h .'luth focclllJ:it prindp.i!. ~pcd fy arnotm!. ar.J!!! indi:t:at~ list what i)'~rioJ uf tm,..,,

I 9, Dimng_!lu~ 6 nw,,nllt rcpomng p,c1~od, qid yoo1 ;,l:th1,11.:s Ul prirpanr.g.. dr,si::m1rmhug or Ct¼U~l/lg lhc d11,..;cnr.aa11ui1 (}f jr;format1tttt:tl materiali i;:di.;;.k tlli: !Iii\: i:>fcmy of the follow in,:;

0 Radio or TV !:i.roadca.is D Mtt,gllilJllt' or nnv,,pilF<,'l'

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0 M,.:,110:11 ph:,ur,: lilms _0 !.c1tcrs ur tcfogrn:,n$

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0 S,odu11M:din wd:mit,cw tmL(i\): -------~ 0 Odie,' {.fpa.:ifi•) ------------------------------------ '-"-"" ____ _ 2<1. Owing this 6 1:nooth rcpn,tillg period, did you di:,~,:mi1,;ii,; ~ cµ•,1$,: \11 !_~ di~~\!lf1iua-1e., inµn'll'l.11i(ln~I m1'!~iJ1L~ ariuJ11g a11y of

thr; followfog. group~: -

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0 01l1er(;;j.•e,:fjjt) ____________ ~----

ll. \Vh4\t l.111'>\i,'W•!\IC w.a1~ ~1sed in th.;i infunuatiso1\a1 mo1te1·iilk

0 Engli~h O Other (.rpecf,~v) _______________ _

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2.3. Did you lebcl c.'.lcli item of S>i.f.;;h infNmntiorml nmtw~ls whil th,:: .,1;.;cemc:n n,rdired hy S:ecrfou 4(b) of the Act? Yt:-> 0 Nn 0

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T A TT "\ /1"\0 /1"\I'\ "1 ,_, 1, rt. A" A l""'f

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APPENDIX ONE - OFFICERS & DIRECTORS

'~': Annette Andrews 277 Perry Street British Human Resources Director

Billericay Essex, UK CM12 ORB

Jon Hancock •.: Ivens Oast British Performance Management Director 01/12/2016 New House Lane Headcom i ,; Kent, UK TN279JiL

Peter Spires 42 Titsey Road, British General Counsel 01/11/2016 Oxted, UK. RH80DF

Paolo Vagnone 7 Gloucester Street Italian Chief Strategy Officer 23/01/2017 Pirnlico

:London, UK SW1V2DB

Vincent Vandendael 11 Leybome Park Belgian Chief Commercial Officer , 03/12/2012 Kew London, UK 'fW93HB

Hilary Weaver 3 Blenheim Gardens, British ChiefRisk Officer 11/11/2016 , Hook Heath A venue, (Previously Interim Chief Risk ' Woking, UK Officer) GU220HL

1

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APPENDIX TWO- REPORTABLE ACTIVITES

21/09/2016 Legislative Assistant

Office of Sen. Al Franken (D-MN)

21/09/2016 Hon. Gary Peters United States Senator

Mike Berman Economic Policy Advisor

21/09/2016. · Ali Houlihan Legislative Correspondent

' Office of Sen. Ron Wyden (D-OR)

21/09/2016 Hon. Debbie Stabenow United States Senator

Sarah Shive Legislative Counsel

Yasmin Rigney Tax Policy Analyst

21/09/2016 Hon. Mark Warner United States Senator

Milan Dalal Senior Economic Advisor

Joe Gunset (Lloyd's) Bill Donovan (Venable) Bart Stupak (Venable)

Joe Gunset (Lloyd's) BiH Donovan (Venable)

: , Bart Stupak (Venable)

Joe Gunset(Lloyd's) Bill Donovan (Venable) Bart Stupak (Venable)

Joe Gunset (Lloyd's) Bill Donovan (Venable) Bart Stupak (Venable)

Legislation relating to private flood insurance.






1

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APPENDIX TWO- REPORTABLE ACTIVITES

21/09/2016 David Carpman Legislative Assistant

Office of Sen. Richard Blumenthal (D-CT)

·. 27/09/2016 Melvin Saunders 1 · Program Manager

Pratibha Goel Financial Analyst

Surety Bond Branch U.S. Department of the Treasury

Joe Gunset (Lloyd's) Bill Donovan (Venable)

: Sabrina Miesowitz (Lloyd's) Charles Landgraf (A&P) Paul Howard (A&P)

insurance.

Eligibility for Treasury recognition as· · admitted reinsurer for certified surety companies.

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\· '.i

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