Charles A. Citrin - Citrin and Walker 1
� ray h a E f
. 8 zz $ 1 ;
? s' 'g a :F
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139 2015 DEC L L f I: L1.Z
www.miamibeachfl.gov
City Clerk's Office C I i °;'' CI F F 11.-ti-
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: C \ LES f\ • CI TR 1A1
Business Name: C E1 ? /U ANY VII AL ER
Address: 330 3-1 st STE 3c I MA &t4 cL 3314/
Office Telephone Number: (305) 8k(- 0999, eXf. 30S
Cellular Telephone Number: (305) 3117- 71
Email Address: C\&S C■4-c i(\& Q O l • cow)
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#.
9
Amount paid: ;, ®a Date paid: 12 1 (;)
Processed by: GorMifr• Date: (L Z 14//
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx
IBC
_ -
{`i �j^q p��Q
:Miscellaneaus Cash Receipt -
'''':''''-':'''''''''r'''''''-y� y ` _ CITY OF MIAMI BEACH Cf■ - -_ - - -
NO t.
:. :.--'- .:-, -- -- 0 :Cash 0 Credit-Card Check# $ o. , :.....: ..:._.i.... 7,..
f
v of- lei i ie - , .
Received
- � a 91.54 ` l i r ;.,'(A rci{ , }e ct.( n . 5-4 e s
`.76-2:Y(-3))Address �
ll t - r `` Fy -? :,„...1.‘
Cl r C j Fo ? 1 1,i C t L"- .J..L.( •�4 °�°} '(THIS•INFORMATION MUST BE COMPLETED) , Of Office of Finan—:-.-L'-'-':-61 rector;
4,4-4. _
Account Humber: k (�: _� .
Preparer. ¢=�_i '( Gt►"`�3.` -�.. _ Dept:.( 1::-1;:.`1, � _ " -
_._ ,c z.Si.,esT'
its'=�-.7 -Ny}fa
....,. .. .:....,_, -
.7„,,,, t
cr r .._
RtiJS..n 4� .. . ,
.• „.
-- __ ...,-
_,,,.....•
each F�oC\da
. ...__
3\t'l
ok r\e mart eft
.\nance 3 31
1 11
1 C1ty - a11 11412315�R I cans#28-J Oerk
1 3.\tI
\,3402°14,2315 3 u�0∎,c - \AC
\Aon 053 00 KJR
20 403363 X533,03
t10R# P pI0 X530
I`OA c}p^ 6)
6hee\' i•
Nave a n\ ce day