David Goldstein/Universal Inv. RECEIVED
03 H~Y 27 P~ 3.' 06
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CITY .,LERK S OFFICE
Ob/of Miami Beach Ofl'g:e of the Ob/Oerk
1700 Co~venUon Center Ddve, Miami Beach, FL 33139
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LOBBYZST REGZSTRA'r~ON FORM
(Oty of Miami Beach, City Code Chapter 2, D~sion 3, Section 2~81)
Q Check Box if an Amendment
NAME OF LOBBY[S'r: (Last) (Rmt) (M.I) DATE QUALm,mu AS LOBBY*~I'
(Zip Code)
1. LOBBY~'~'T RETAINED BY:
~szN~s ~D~: (Num~ and ~et) )
~HONE NU~; F~ NUNB~: (O~onal) EN~L: (O~onal)
Fill out this secUon if prlndpal Is a CorporaUon, Parhlemhlp or Trust [Section 2-482 (c)]
· NAME OF CHIEF OFFICER, PARTNER, OR BENEF~OARY:
· LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP IN I r_~EST IN SUCH
CORPORATION~ PARTNERSHIP OR TRUST:
SPEC/FZC LOBBY ISSUE:
Zssue I:o be lobbied (~be in detail):
In'. ~, i Y AGENC~ES/TNDIV~DUALS TO BE LOBBIED:
H,qY 2'7 2003 25-" 16 FR NRTIOhlS~F:ti',iK
z)
~x,~j' F..xpt~ Febrile/11,200e
I~nt, stamp or type name ~ No. fy public
Di&TA ~ DA'~.z _
· ~ TOTRL PRGE.02 **