N.Y. Comp. Codes R. & Regs. tit. 19, § 942.3
(e) In the request for exemption, the covered person shall state that:
“My Client is not currently receiving my services or seeking my services in connection with: (1) A proposed bill or resolution in the senate or assembly during the reporting period; (2) A contract in an amount totaling $10,000 or more from the state or any state agency for services, materials, or property; (3) A grant of $10,000 or more from the state or any state agency during the reporting period; (4) A grant obtained through a legislative initiative during the reporting period; or (5) A case, proceeding, application or other matter that is not a Ministerial Matter before a state agency during the reporting period,” and
(f) The request for exemption should include but need not be limited to the following information: