Wittek Development, LLC
&
City of Miami Beach Office of the City Clerk
1700 Co"venllon C~ter Drive. Miami Beach, 1'1. 33139
Emai1: cityderk@d.~i-btith,t1.U5
LOBBYIST REGISTRAnON FORM
(City of Miami Beach, aty Code Chapter 2, Division 3, SectlO" 2""1B1)
c Check Box If an Amendment
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NAME OF LOBBYIST: (Last) (First)
10 0 s: e... .Q1'.l b S-t12-E€1"" S\,lA'I€ 3era.o I
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BUSINESS ADDRESS: (Number Brld Street) (CIty)
305 -"3/I.f- !; '3 tf3 3 o~'"?1 '1-'0'5 if
TEWHONE NUMBER: FAX NUMBER:
X. ~11310d-
(M.!) DATE QUAlIFIED J\S LOBBYIST
~"'lWtI ifL 3~/3/
(Stale) (Zip Code)
a ',+z:t~ M-"S@- a..t I. c..o WI
EI1AIL:
L LOBBYIST R!TAINED IY:
W l-r:=\'1; 1<. D EV€.Lo P ~ I\J'I, LL-~
NAME OF PRINOPAlJaJENT:
4 ~a.. r LA WI. M 'il. [1: ~'\~ f="Q~.t)
BUSINESS ADDRESS; (NUmber alld street:~ (CIty)
.!l.o ~ - 3~1- S(p()O
TELEPHONE NUMBER: FAX NUMBER: (Optional)
I C-r
(Slate)
o(perO{
(Zip Code)
EMAIL: (Optional)
Fill out this section If principal" a CorporaClon, Partnership or Trust [hctlon a-482 (e))
. NAME Of CHIEF OFFICER, PAll.TNER, OR BENEFtOARY: t lA.(l..~ vJ I <"t1l'l (...,
. UST ALL PeRSONS I1OL.DING, DIR.Ecn.y OR. INDIR.I!CT1.Y, A 5% OR MORE OWNERSHIP INlEREST IN SUCH
CORPORAllON, PARTNERSHIP OR. TRUST: k:..u i.<\ vn'1""t'E..-1L
II. SPECIFIC LOBBY 1SSUE:
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Issue to be lobbied (Describe in detail):
m. CITY AGENCIES/lNDMDUALS TO BE LOBBIED:
A) Full Name of IncIlvIdual/lltle B) Rel.tionshlp
Ct\.~._~C;:~Q.,I4,~I.i'dff.'~ ~ ~
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IV. DlSCLOSUR.E OF TERMS ."D AMOUNTS OF LOBBYIST COMPENSATION (DZSC::LOSE WHETltER HOURL r,
FLAT RATE OR OTHE/I~
jgDO /4..
A) LOBBYIST OISQ.OSURE:
-It 3t)o/~r
.
B) PRINCIPAL'S DISCLOSUru: (OF L.OBBYJST COMPENSATlON):
V. SIGNATURE UNDER OAnt:
ON OCTOB~R lIT OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERIC A SIGNED
STATEMENT UNDER OATH, LImNG LOBBYING EXPI!NDITURES IN THE CITY OF MIAMI BEACH FOR
THE PR,ECEDlNG CALENDAR YEAR.
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions co . "ned in Section 2-482 of the Miami Beach City Code as amended, and all
reportIng requirements,
Signature of lobbyist:
Signature of Prlndpal/Olent:
VI.
LOBBYIST IDENTlFICAT10N: ~
fDL 1t '1'2-5 2- -co'1..... \:S"-- 2. 9J -0 --4ff1<1tt-ll9..r:r;: I q d-,m! .s
/' f'D UF $3 110- I COI..... )b .. t./S-f, ~ 0 -)/trv ie' AI<;l vt\ H .tt"CitJbe{
av' Produced 10
Form of Identification
r:J Personally Known
YD. SIlIlNATUIU AND STAMP OF NOTARY OR DEPUl"'t' CLERK:
State of Ronda, County of Miami-Dade
Swom to and subscribed before me
This Jt{ ~ day of tJt.H'-L . 2002.
N YSEAL
ULlJAN BEAUCHAMP
NOrARY PUBLlCSI"ATEOF FLORIDA
COMMISSION NO, DDl09289
MYCOMMISSION EXP. APR. 29.2006
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Signature of Pub/fc Notary - State 0 Ronda
L '/ (r'q N Be a Uctt q htit
Print, stamp or type name of otary Public
Registration:
/ACCEPTEO
FOR CLERIC'S USE ONLY
[ ] REJECTED DATE:
-r II~ (O~
If rejeded, state n!lIson: /
, Reglstmlon !'ee paid: ['-'[Yes [ ) No Z/f l( r z,""2
~ )'1 I []~sh[ ]Check MeRit I( -"
. '7 eoJe ,,. CarOl I
'1 pATA ENTRY DATE: C, I t./ 7 Od--: 2002 ENTERED BY: ~
I AISt R.vlskln - 05/17/02
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