Motorola
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Oty of Miami Beach 0fIice of the Oty aerie
1700 Convention Center Drive, Miami Beach, Fl33139
Emall: dtyder1c@d.mIami-beach.tl.us
LOBBYIST REGISTRAttON FORM
-
(Oty of Miami Beach, Oty Code Olapter 2, Division 3, SectIon 2-481)
65 Check Box I' an Amendment
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NAME OF LOBBYIST: (Last) (First)
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BUSINESS ADORESS: Nu rand Streetl (Oty) (State)
[.30$t 53"-(( (.Q L-:3a;)!B~-lllle>
TElEPHON NUMBER: FAX NUMBER:
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(M.I)
DATE Qlj~ AS LOBBYIST
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(Zip Code)
~.bm
EMAIL
L LOBBYIST RETAINED BY:
~(ola ~.rI(lLJ~
NAME OF PRINOPAl/CUENT:
(Oty)
(QS'l) ..,~~-l(~y
FAX NUMBER: (Optional)
EMAlL: (Optional)
[ClS't ') fJ!B- ~q() I
TELEPHONE NUMBER:
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Fill aut this sectfon If prInc1pl1J Is . CDt~.Jh"., hrtnenIIlp 01' TJWt [SectIan 2....2 (e))
NAME OF OiIEF OFACER, PARTNER, OR BENEACIARY:
~h5boJu/ ~I~
UST ALL ~RSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR. TRUST:
fYntL &fD(ttfw1
U. SPECIFIC LOIIV ISSUE:
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Issue to be lobbied (Descri:lin detail):
-
SlJ-
,
m. CITY AGENQESjINDIVlDUALS 10 IE LOBBIED:
A) Full NlIme fill 1nd1vldu.I/T1IIe
I) RIIr.t1on1hlp
r .
IV. DISCI 0Sl1RE Of 1BtMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCI 05E WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:
.
~~ (A.Ah I.M
(/ 3 OD.(t)
B) PRINCIPAL~ DISCLOSURE (OF LOBBYIST COMPENSATION):_ru III 'd 1nJ-t ~l fV\ ~ jf\I'\.llr'\\.lltr
b().JUD
Y. SlGlNAlURI UNDER OATH:
ON OCTOBER 1'" OF EACH YEAR,. EACH LOB8YISI'SHALL SUBMIT TO THE CITY a.ERK A SIGNED
STATEMENT UNDER OATH, U5rING LOBBnNG EXPENDITURES IN THE CITY Of MIAMI BEAat 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. L08I1Y1ST IDENTIFICATION:
.. Produced ID
Form of Identification
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YD. SlGlNAlURI AND STAMP OF NOTARY OR DEPUTY WRK:
f" .
... NOJ'ARYPi
COM,'"
MY COrvi
'.f1lNJlZ
,n OF FLORIDA
\10. CClIS']]?
:iXP. Y 28
State of Florida, County of Miami-Dade
Sworn to ~nd SUbscri~e ~e
This [7. day of 2002.
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FOR a.ERJ('S USE ONLY
Registration: [] ACCEPTED [] REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No
[ ] Cash [ ] Check
DATA ENTRY DATE: 11
1
MCR#
2002
I First Revision - 05/17/02
Sent By: MOTOROLA; 9547238779;
Jl.I.'T~Z002 ":1111M F....1I. CAIl\lEIlAS REIAIC
17 Jun 02 3:24PM;Job 880;Page 3/3
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A) LOlIIIY1$T!)ISO 0SI'.e:
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I'tAT"''' 0lII OTHEIf}r
8) PltDICIlW.'S ()lSQ 0S'1lU! (Of' ~ST alMI'l!N5ATXIN)'
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ntl.+6" If.. CH-'YUL
[ dO saIernnIy swear that lit or ~e ftlregOlng l'IaI .~ tnlelflcS CXlI'IC ....:I tNIt
flmlllar WIth !he pnwiIions conCllned in Secdon 2-412 f1l the Hilmi 8Mch City
reporting requltwnenIlI.
SlgnaIu... of Lobbvllt:
, ,
Slgnllbn of PrinclPilII
VJ. WI ...~
4 Pn:lduc:ecl ID
Fcrm of IdentJfialtiOn
4 PenoMtIy Known
w:a. _______.... __ .........CUIIII(r
Stare C'I Fforlda, County d MIiJri-Dade
SWom to and Slbscrtbed before me
This _ d . 2002.
Signature r:I Public Ncrarv -
Print. stIInp 01' type Nlme d
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JUL-ON002 12:5ellM FROM-TEJ CAR10AS IlE8AK
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