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Loews Hotel <-. '--- ...~ 11 m City of Miami Beach Office of the Oty Oerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: dtyderk@d.miami-beach.f1.us LOBBYIST REGISTRATION FORM - (eity of Miami Beach, Oty eode ehapter 2, Division 3, Section 2-481) .s Check Box if an Amendment Sansbury , NAME OF LOBBYIST: (Last) ?1ichael (First) (M.I) DATE QUALIFIED AS LOBBYIST 6800 Iakewood Plaza Drive. Orlando. Florida 32819 BUSINESS ADDRESS: (Number and Street) (Oty) (State) (Zip Code) (407) 503-9001 TELEPHONE NUMBER: (407) 503-9003 FAX NUMBER: msansburv(cl1oews . can EMAIL: L LOBBYIST RETAINED BY: Loews Hotels. Inc. NAME OF PRINCIPAl./Q.IENT: 667 r-1adison ~venue. New York. New York 10021 BUSINESS ADDRESS: (Number and Street) (Oty) (State) (Zip Code) (212) 521-2000 TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if prindpal is a Corporation, Partnership or Trust [SectIon 2-482 (e)l ? NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY: Jack Adler, President ? LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN sueH CORPORATION, PARTNERSHIP OR TRUST: Loews Hotels, Ine..,;is an indirect wholly-own subsidiary of Loews Corporation, a publicly held corporation. Laurence A. Tisch and Preston R. Tisc..h own an aggregate apT?roximatelv 31% of the corrmm s oc 0 J....oews Corporatlon. n. SPECIFIC LOBBY ISSUE: Anv and all mat-:t".p-rs rp-lat; nq rn r hp T,()p~ ~"i ....mi RD....~h J.frIt-P' Issue to be lobbied (Describe in detail): m. CTY AGENCES/INDIVIDUAlS TO BE LOBBIED: A) Full Name of Indlvidual/Tltle B) Relationship z..tiami Beach Redevelopnent Agency None Cit" Cc:mnissioners and Mayor None City Manager and Assistant .t1anagers None Board of Adjustments, Hotel Selection Ccmnittee None and Planninq AdVisory Board " City Staff None . ./~.. ~ .. . 4. Identify each individual (Commissioners, Board, Committee, Authority member or City staff) to be lobbied: City Cornnissioners and ~1ayor, City Manager and Assistant Managers, City Staff, Board of Adjustments, Hotel Selection Conmittee, Planning Advisory Board, Redeveloprent Agency . 5. The subject matter in number three (3) above is to be eonsidered at the meeting of (Identify eaeh entity or individual): Unknown . a The Oty Commission a City Commission Subcommittee a City Staff a City Board or Committee a Personnel a Identify Others .2001 .2001 .2001 .2001 .2001 .2001 on on on on on on 6. State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above: None. ON ocrOBER 1 sr OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. I do solemnly swear that all of the foregoing facts are true and eorrect and that I have read or am familiar with the provisions contained in Section 2-482 of the Miami Beaeh Oty Code as amended, and all reporting requirements. ~ ~~.-"~ 5ignatureofLobbyist~"'YV 0 ---- I ~ ~~~:rI~own JIL i)~ Ue,,r,,,,,tJ' SfLI m FL 'lIt, tJ f Identify a Did take an oath, or a Did not take an oath OR~"\a.- State of Florida, County of Mienli Dade Sworn to and subscri~ before me This..:} t.:llA. day of 6.o~2001. ~ ~O~~"' ~ . ~ , Notary or Deputy aerk 'inLcnIne T 0II0n . . ~ nnM8l100 If Notary, prin~ ~.,!!_mmissioned Registration: [~PTED FOR CLERK'S USE ONLY ~ fi [ ] REJECTED DATE: / () R 0;;;>--' I ' If rejected, state reason: Registration fee paid: [ ] Yes [ ] NO/1 ] Not-for-Pr It [ ] Cash [ l1'Check MCR It DATA ENTRY DATE: .2001 ENTERED BY: