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Donald J. Washburn - The Audio Bug, Inc. I,At' \1 City of Miami Beach �� � '+ 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov i '` C:L__[ 6 �`� OFFIL City Clerk's Office • Tel: 305-673-7411 Fax: 305-673-7254 Office Use Only ANNUAL LOBBYIST REGISTRATION FORM Name: Donald J. Washburn Business Name: The Audio Bug, Inc. Address: 3800 Hillcrest Drive, Unit 102, Hollywood, Florida 33021-7937 Office Telephone Number: 954-983-2788 Cellular Telephone Number: 954-881-6036 Email Address: audiobug1@aol.com If more than one lobbyist,please list: 1) 2) 3) 4) 5) 6) 7) Submit this form to the Office of the City Clerk, along with a check for $500 for each lobbyist. Please make the check(s) payable to the City of Miami Beach. For City Clerk's Office Use Only MCR#: yV SOCA Amount paid: ( 00,°e Date paid: \ )V1 3 Processed by: '"' O ( O'(Th' Date: ` F:\CLER\$ALL1aFORMSILOBBYIST FORMSIANNUAL LOBBYIST REGISTRATION FORM reg.docx Miscellaneous Cash CITY OF MIAMI BEACH `'` f i''`�`1 1-y 4:, e� 0,49-9 g5, .U9 toi iL 3 _ •T' .a t # - �` R 7 El Cash C7 Credit Card heck ., O`er \;. 20 I-j. S' Received`of V')O'flC \cL '• ` 4- � Address I�� � � ,�J j,� F�� ,� � ) is� [�.- �' � �-1 .� �4."`� ��4 5 car. �..A�"l i..� y ���.., �..� ` -� �t._ For ' 0 _ r ; t " + . f3 c-, -�1 ,, t c: j it '''''-'- ;-: (THIS INFORMATION.MUST BE COMPLETED) D� 9_fffce®f Finance D�rec or F� , .mac - , _ - _ - - : Account Number. +1 a �,� :' `( J Pre arer: - 1 -�1 ( e �° t / ,/T',p � - _ ��� Dept: � �~ fin:-,L :EXT': ��� •