M.B. Redev. Inc c/o John Tacke
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aty of Miami Beach Office of the aty Oerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: dtyderk@d.mIami-beach.n.us
LOBBYIST REGlSTRA110N FORM
(Oty of Miami Beach, aty Code Chapter 2, Division 3, Section 2-'181)
.or Check Box If an Amendment
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NAME OF LOBBYIST: (G;t)
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(Arst)
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(M.I)
DATE CSJAU~~ LOBBYIST
. ~I?I
(Zip Code)
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EMAIL;
r and Street) (aty)
.L60s) S3b-1 ( I b
FAX NUMBER:
L LOUYISr RETAINED BY:
--H. b. ~D I I, Q S\ ~ n ~ . ) (}yo ~
NAME OF PRINCPAl/OJENT: U I
(.10 ~r) <-fLf a. d..P...v
/fa1J I ~ U)#.Ju-U..
BUS{NESS ADDRESS: (Number and Street)
(boS) 1DxH- IlOo{
TELEPHONE NUMBER:
J V'U..I f7rvtA, &lLl'~.
(aty) '(State)
fZ{ J31.s9
(Zip Code)
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out..... MdIon " prilldi* .. . CaI)IoIlItI..n, PlIrtnenhIp or Trust [SecIIon 2....2 (e)]
NAME OF CHIEF OFFICER, PARTNER, OR BENEFIaARY:
UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARiNERSHIP OR TRUST:
Do SPECIFIC L08BY ISSUE:
b..ld_.LI\~'1l :;f,rUf'l)rlf) rO"", n&,n;hlYV,C} &,.-,C+/ht> (:,,~ ~~O(f"lrOlgjp
Issue to be'idbbied (Describe n oetail): ---'. . ~ n AI.. /I .. .. .. . .
~ a)) {faCl\ ('ell DO, t..4 ~
m. CITY AGENaES/INDMDUALS TO IE LOBBIED:
A) Full fUme fII IndIvlcIu../11tIe
8) ReIIItiouhlp
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f>D.a Ad
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IV. DISCI 0Sl1RE OF 1&MS AND AMOUNIS OF L088YIST COMPEN5AlION (DISCI 05E WHEllIER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:
'Quo.oo (ho14 rJ~(J} \
B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
Y. SIGNATURE UNDER OATH:
ON OCTOBER I-OF EACH YEAR. EACH LOB8YJSI'SHALL SUBMIT TO mE CJTY a.ERK A SIGNED
srATEMENT UNDER OATH, U5r1NG LOBBYING EXPENDITURES IN THE CJTY OF MIAMI BEACH FOR
THE PRECEDING 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 contained in Section 2-482 of the Miami Beach City Code as amended, and all
reporting requirements. ~
Signature of Lobbyist:
Signature of Prindpal/Client:
VI. LOBIIYIST IDENlIFICATION:
Jl! Produced ID
Form of Identification
Jl! ~,=,na"y K;;;;Fl~
YD. SIGNATURE AND Sf AMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
swom! and SUbscriJmre me
This ~ day of ~. 2002.
Print, stamp or type name 0
YOHAMI LAM GUERRA
DO re7535
U IRES: January 29, 2006
---.y-~
. FOR CLERK'S USE ONLY
Registration: [] ACCEPTED [] REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No
[ ] Cash [ ] Check MCR #
pATA ENTRY DATE: ~ I f . 2002 ENTERED BY:
I First Revision - 05/17/02
STATE OF FLORIDA, COUNTY OF MIAMI-DADE
SWORN TO AND SUBSCRIBED BEFORE ME
THIS DAY OF , 2002.
Signature of Public Notary - State of Florida
Print, stamp or type name of Notary Public