The Abbey Hotel c/o Keith Space
06-21-Z00Z 10:Z8AM F~TEW CARDENAS REBAK
+3055361116
T-166 P.ODZIOD4 F-87Z
in
-
City 01 MiImi BelCh omce of lhe City Cletk
1700 ConvenIlon centllI' Drive, Miami BelCh, FL 33139
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LOIIIIYIS1' REGlSTRAnON FORM
(City of J'oIIami e..dI, QlY COde CMpl8f' 2, Oivl&iOn 3, 5eClIOR 2-181)
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NAME OF L.OB8Y1ST: (LaSt) (first)
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BUSINeSS ADDRI!SS: (lUiiber ~nd Street) (City)
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TELEPHONE NUMaER: fAX NUMBER:
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(M.I) DATE QUALlflED AS l.Oll8YlST
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(staIIll) (Zip Code)
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EI'IAIL:
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NAME Of PII.lMCIPA~CLlE'ifit)
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BUSINeSS ADDIll! : (Number ilIld 5tfl!e[) (Qly) (5t.-le)
l~~ 53 HXJ:3. \ (:os) ~I~~
TELEPt1QNE "'UMBER: fA)( NUMBER; (Optional)
o ~.~I.:1,er
(Zip Code)
EMAIL; (Ol'ionil)
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~6it Of5lW&eNEFlClARV:
? LIST AL~ PERSOtlS HOLDING, DIIll!CTLY OR INDIRECTLY, A 5'lb OR MORE OWNERSHIP INlEREST IN SUCH
CORl'ClAATION, PARTNERSHIP OIH1W~....J. J /", "'....<MJ:./, A.... II d.6. __.L () ~
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II. SPECII'IC LOlIIY 1SSUI!:
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lSIue to be lObbied (De<<ribe in dliTail):
"Ll4 A..J
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., _l1li..111.
06-fS-ZOOZ 10:Z8AM F~TE' CARDENAS REBAK
+3055361116
T-166 P 0031O~ F-BTZ
IV. DIKlos"ld 01' TalM5 AIID AIIIOUII15 01' LOR'IISTCOMPlllSATIClN (.... ~ WMEntl!Il HOIIRL r.
FlATRATEOR UTH'R):
A) L086Y~ DI5O.OSURE:
,. .11 A\H ~t1 ,.A IJ :tt. ";.D (j 2.2..5. t)O
6) P1UNClPAL'S DISCLOSURE (OF LOIlllYlST COMPENSATlOH):
V. IIGIIATUldUltDEA~TH:
ON OCTOIIallST OF EMJI YIiAII. EACH L()eBtIST sttALL SUBMI1' TO lIt5 CI1Y C1IIUC A 5I;r_
SJATEMI!NT U.... OAlIt, LJSTING LOBBYING ......ENDnURES IN lit': ClTY Of MIAMI BEACH FOR
11tI! PRKff'"4G cu -=-.&R YPR.
Signature of Lobbyist:
Signature of Principal/Oient:
VI.
"s PrOduced 10
ft..I)L. S IV>' Sfb-b7 --z.Sr - 0
Form of Identification
"r Personally Known
vu. SIlIIIA1\IU AN>> srAMP OF IIGTAllY oalJEllUl'Y a.DICJ
State of Florida, CDunty of Miami-oacte
sworn to and subscril:led before me
This Ol C day d ;J vV'! , 2002.
~ a\. Axel L.cau
. .~ . My Comrf1isIIOn De111111
'~I ExpireS January '17.2011
of Florida
ry Public
FOR a.BK'S USE ONLY
Registration: [1 ACCEFTEO [) REJECTED DATE:
If rejected, state te8son:
RegistratIOn fee paid: [ ] Yes ( 1 NO A
( ]~ [ ] Check MCR# //
DATA ENTRY DATE: ,I l f I ~OO2 eNTERED 8'.>:1) .}6)
I I I r---L ,
I First Rc\IlSiOn -115/1'102
~
Q6-%5-Z00Z 10:Z8AM F~TEW CARDENAS REBAK
+3055361116
T-166 P.OO./O~ F-8TZ
STATE OF FLORIDA, COUNTY OF MIAMJ-DADE
SWORN TO AND SUBSC~~;EFO~ ME
THIS I()~ DAYOl: 2002.
fbr &Jb &1 ~ h:ienV-
.UlflJ k~~
Si of Public ~otar)' - State of Florida
Print. s.;;;.":: ~"i Public
'\;.:Y Exp!leSAugual12. 2002
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