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Client Registration: 2022  
Registration Information:
Registration Status: Concluded
Authorizing Officer name Evann Whitelam
Title Designated Agent for Filer
Business name Form Energy, Inc.
Address c/o 2350 Kerner Blvd., Ste 250   
City, state, zip code San Rafael, CA 94901         
Country US
Phone 415-389-6800 
Employment Information:

Account Type:   Lobbyist Entity
Authorizing Officer Name:  
Jed   M.   Nosal
First   Middle   Last
Employed By:   WBD Strategies LLC
Street 1:   470 Atlantic Ave
Street 2:   Suite 600
City, State, Zip:   Boston MA 02210
Country:   US
Phone:   857-287-3175
Primary Email Address:   jed.nosal@wbd-us.com
Additional Email Addresses:   beth.mullen@wbdgov.com
Agent Type  
Date of Employment   01/01/2022
Date of Termination:  

Account Type:   Lobbyist
Authorizing Officer Name:  
Nina     Peluso
First   Middle   Last
Employed By:   Form Energy, Inc.
Street 1:   c/o 2350 Kerner Blvd.,
Street 2:   Ste. 250
City, State, Zip:   San Rafael CA 94901
Country:   US
Phone:   415-389-6800
Primary Email Address:   npeluso@formenergy.com
Additional Email Addresses:   formenergy@nmgovlaw.com
Agent Type   Both
Date of Employment   04/19/2022
Date of Termination: