MB Development, Inc. c/o J. T.ob/o1' Idlami Beach Olde m' the Oty Oerk
1700 Ctmventlon Otrfl~ DI4Wa, Idiami 9each~ FL 33139
LOBBYISt RL~La~ i~A1/ON FORM
CC. lb/olr Idllmi ~ Oty Code Chapter 2, Dfvlsiofl 3, Section 2-491)
(zip C.~de)
' iE~,IA~L: (O~tlonal) ' '
Iqll mat this mldlm H' pr~ b a cmporothm, PuMp m. Trud: [Secth~i 2..482 (C)]
? NAME OF CHIEF OIR~CER, PAR'T'NI~R.,. OR BENERC/ARY:
? LT5'I' ALL PERSON5 HOI. D~NG, D]HTECTLY OR ZND[RECTLY~ A 5% OP. MORE OWNERSHZP iNTEREST ~1 SUCH
CORF~RATLON, P/t.~TNERSH'ZP OP, TRUST:
lssue~ofoeldbloied(Doscdl0ern'cte~all): ~ ~ [~1 (~0..~ O..CL~.tJ~., U
ZgO-d ZOO/ZO0'~ tO£-L gIILg£990£+
XYgH~ SYNergY3 ~gL'ROa~ Rd90:60 ZOOZ-BZ'90
~V. I~SCLO~IlI~ OF TBAP, S AI~D A14OU~lS ~F LOBBY~ST I3~4P~#~AT'~OII ~ WHrI~E~ HOURLY,
PLAT KATE OR OTHER):
!
~ U#DIB~ OAllh
STATI~4ENT UNDER OATH, I.I~r-NG LQBBYZNG EXPENDZTURES ZN THE cl'rY OF IRZANZ BEACH FOR
THE I~=CF.D]Ne CN. ENI~ ~
! do solemnly swear that all of the foregoing facts are true and correct and that ! have read or am
familiar with the provisions co~tained in SectJon 2-482 of the Miami Beach City Code as amended, and all
reportJng requirements. ~
Signature of Lobbyist::
Produced ZD
Form of ZdenUficatJon
State of Rortda, County of Miami-Dade
Sworn_tp and subscribed before me
5ignz ry - Stalz of Florida
Pdnt, stamp or Lype name
ReglstraUon: [ Pit::u [ ] RE~EC(i::D DATE:
P. egl:,~,d~on lee pold: [ ] Yes [ ] ~
£ ]cash [ ]o,e~
DATA ENTEY DATE: ,2002 ENTERED BY:
I RPst Revision - 05/17/02
,ZgO-~ ZOO/;OO'd
9LLL9;g60£+
NYg~ $¥N~Oa¥3 i]£'fl0~d ~dg0:g0 Z00Z-SZ-90
STATE O1~ FLORIDA: COUNTY O1: MIAMI-DADE
SWORIq T~AND SUBSCRIB~ED BEFORE ME
THIS_ ~ DAY OF ,JO ~ ,2002.
Signature of Public Notary - State of Florida
lgO-~ /O0/~O0'd POg-£ 9LLLgs990S+ X¥99a $¥NgOaV~ ~ai-l'(oaH RdgO:90 ZOOZ-OZ-90