Lobbyist Fee Expenditure & Compensation FormCity of Miami Beach
Lobbyist Fee Expenditure and Compensation Form
CALENDAR YEAR 2007 City Code Section 2-485
Due:
Expenditure for period of : through
A statement shall be filed even if there have been no expenditures or compensation during the
reporting period. In order to withdraw as a lobbyist on an item which is no longer being lobbied,
initial in the appropriate space. Any item requested to be withdrawn will be removed
for the reporting period of:
through
Lobbyist:
Principal:
Subject Withdraw
YES NO
Detail Compensation Received: _
CATEGORIES OF EXPENDITURES
Food Beverage:
Entertainment:
Research:
Communications:
Media Advertising:
Publications:
Travel:
Lodging:
Special Events:
State of Florida
Oath
County of Miami-Dade
I, the undersigned lobbyist, do hereby depose under oath and affirm that the information disclosed herein and any
attachment hereto are true and correct.
Signature
Sworn to and subscribed before me this
Notary Public
My Commission expires:
day of _ , 200_
This form is to be signed, notarized and returned to the City of Miami Beach, City Clerk's Office, 1700 Convention Cente
Drive, Miami Beach, FL 33139 by October 1st. A fine of $50.00 per day shall be assessed for reports filed offer the du
date. If you require any assistance please contact this office at 305.673.7411 or at Cityclerk@miamibeachfl.gov_