Wayne Brackin Annual Lobbyist Registration Form Pa/k
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City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www..rniamibeachfi_gov
City Clerk's Office
Tel;: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: Wayne Brackin
Business Name: BAPTIST HEALTH SOUTH FLORIDA
Address: 6855 Red Road, Coral Gables, Florida, 33143
Office Telephone Number: (786) 662-7111
Cellular Telephone Number:
Email Address- WayneB @baptisthealth.net
If more than one lobbyist, please list:
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Submit this form to the Office of the City Clerk, along with a check for $5)0 for each
lobbyist. Please make a check(s) payable to the City of Miami Beach.
For City Clerk's Office Use Only
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