VIRGINIA CONFLICT OF INTEREST AND ETHICS ADVISORY COUNCIL

Lobbyist Registration Form (Rev. 10/2016)

There is a $100 fee required for registration (local government employees are exempted from this fee). This form must be submitted electronically on the Council's website at ethics.dls.virginia.gov.

PART I: PRINCIPAL INFORMATION

Please provide the name of the Principal for which you intend to lobby

1.NAME OF PRINCIPAL:Waymo LLC
Permanent Business Address:c/o 28 Liberty Ship Way, Suite 2815 Sausalito, CA 94965
Business Telephone:4159032800

Please provide the type of business the Principal is engaged in

2.Type of Business:Autonomous vehicle

Please provide the name of the individual authorizing your employment as a lobbyist. The lobbyist filing this registration MAY NOT be the same as the Principal Officer.
3.NAME OF PRINCIPAL OFFICER:Erin Lama

Permanent Business Address:28 Liberty Ship Way, Suite 2815 Sausalito, CA 94965

Business Telephone:415-903-2800

E-Mail Address:elama@politicomlaw.com

Please provide the name of the individual who will retain ALL records, on behalf of the Principal, with respect to your lobbying activities for their organization, if different from the Principal Officer.

4.NAME:Erin Lama

Permanent Business Address:28 Liberty Ship Way, Suite 2815 Sausalito, CA 94965

Business Telephone:415-903-2800

E-Mail Address:elama@politicomlaw.com

Permanent business address and telephone number of location where records are stored, if different from above:

28 Liberty Ship Way, Suite 2815 Sausalito, CA 94965 415-903-2800

PART II: LOBBYIST INFORMATION

Please provide the name of the Lobbyist registering to represent the Principal listed in Part I, item 1

1.NAME OF LOBBYIST:Benjamin Blink

Permanent Business Address:c/o 28 Liberty Ship Way, Suite 2815 Sausalito, CA 94965

Business Telephone:4159032800

E-Mail Address:waymo1@politicomlaw.com

Please provide the name of the individual who will retain ALL records, on behalf of the Lobbyist, with respect to your lobbying activities for the Principal identified in Part I, item 1, if different from the Lobbyist listed in Part II, item 1

2.NAME:Erin Lama

Permanent Business Address:28 Liberty Ship Way, Suite 2815 Sausalito, VA 94965

Business Telephone:415-903-2800

E-Mail Address:elama@politicomlaw.com

Permanent business address and telephone number of location where records are stored, if different from above:

28 Liberty Ship Way, Suite 2815 Sausalito, VA 94965 415-903-2800

Identify the subject matter (with as much specificity as possible) for which you expect to lobby

3.SUBJECT MATTER:Matters affecting autonomous vehicles

Describe your relationship with the Principal listed in Part I, item 1 (check only one):

4.As a lobbyist, you are:

Employed (on the payroll of the principal)
Retained (compensated but not on the payroll of the principal)
Not Compensated (not compensated but expenses may be reimbursed)

If you are employed by the Principal provide your job title

5.JOB TITLE:State Public Policy

I, the undersigned lobbyist, do state that the information furnished on this registration statement and on any and all accompanying statements attached thereto, is to the best of my knowledge and belief, complete and accurate.

Date: 5/1/2025 4:49:04 PM Lobbyist Signature: Benjamin Blink (Electronically Signed:5/1/2025 4:49:04 PM )

Note: Pursuant to § 2.2-423, a principal may elect to waive the principal signature requirement on disclosure filings by submitting a signature waiver form to the Virginia Conflict of Interest and Ethics Advisory Council after this registration form has been approved.