Thomas Sherman Corsica Resd.JUN-25-03 nS:40Pld FROM- T-48T P.02/03 F-Z43
of Miami Beac~ Oflqce of me C3:y Clef~
LOBB~ ~GZ~ON FORM
218 Almeria Avenue ' Coral Gables F1 33134
~SIN~S ~O~5: (Num~ a~ ~) (~)
305-448-5898 305-445-44B8 tomguni ontitleservices.
T~ONE NUMBS: F~ NUMBS;
LOBIIY~ST ILL~rAXNED BY:
CORSICA RESID£NCES, INC. c/o JEAN-CLAUDE REBOUL
NJU~E OF PRINCiPAL/CLiENT:
1501 VENERA AVENUE, 5TE. 207 CORAL GABLES FL 33146
BUSXN~SS.ADDRESS: (Nmber arIG Street) (OLY) ~ (Star~) (711: Code)
305-663-6550 305- 663-0662
'T~L~P~C~E N'--'"'~"''-~MBER: FAX NumBER: (Op~al). EMA,T~L: [Opaonal)
FIX Qut: ~is sOc:tlan if pr~ndpal is a CoclaQraUofl, Partnership m' Trust [Section 2-40~
· NAME OF C:}~EF OFFICER, PAR _TI~:R, OR BENEFXCXARY:
· ~lean-Claude Reboul
· LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% aP. MOR~ OWNERSHZP ZHT~REST m SUC~'
COILaoRAT~ON, p~x]P O~
Jean.Claude ~boul, .Paul Gir~ud
SPErTFXC ~BBY ~SSUE:
DETERMINATION OF LEGAL NON-C"ON. FORMIT~
Iscaue to De IOD~eG (DeSCrl~e in
s,~.l----~ &G~/ZHD~'rzDUALS 1'0 BE LGBBXED:
A) Full Name ~ Xndivldual/TIUe
JORGE GOMEZ, PLANNING 0IRECTOR
RICHARD LORBER
MERCY LAHAZARES
8) Retat~anShip
NONE
NONE
NONE
JUN-Z~-03 O5:41PM ~ROM- T-487 P.o3/a3
B) pRINC]PAL*SDLCt~SURE(OFLOBBYL%'TCOIvIPEN~AT]ON):- ~ ~(:~<~, ~)<.~ ~.,~' ~,..e~,~-"~
F-Z43
Pur~mnt ~ Ordinance No. 2nn~-:]3~3 A,~,*~dl,"~ N~mi ~n~ O~ ~e. ~m~ 2. A~e ~. ~o~
~maai~n .~m~s ~ Lo~i~ On ~rement
~ you ;~;~fl~ off a m-~-q~ or ~a~in~ bid ~or c~d~. ~ulam~t ~'~- or on a a~nt
or ~ndine awa~ f~ ~s. eaui~nt ar ~i~? g Y~ I No
~uant ~ Ordinance No. 2g03-~3~3 Amen~lna Miami B~
· er~f ~n~U~ '~m0aian ~e Ref6~% Via ~e
~m~ian ~bu~ons By I ~ O~ Real P~re
Are you lobby:no on a eendima amallcatlon for a I:c-::."oament Aoreement with the City or
aoaliCaUon for chanae Of zoniilq mad desianation or chalt~ete the city's Future La~d L;-~ Mae?
V, 5ZGI~TURE UNDER OATH:
,.m O~-rOBER 1~r OF EACH YEAR, EACH LOBIY~ SHALL $UBMI'I' TO THE ~ CLERK A $ZG~ED
~'~'T~I~£NT UNOER OATH, !.T_~r~NG' LoaaY~NG EXPENOTrIJRES ZN THE CZTY OF MZAMZ BEACH FOR
THE PRECEDZNG CALENDAR YEAR.
! do solemnly swear that all of the foregoing fa~_< are true and correct and t~at ! have read or am
familiar with the provisions contained in S~n~2-~2 or the Miami Beach City Code as amended, and all
reporting requirements.
,-, Produced :ID . rsonally Known Form of Identification
V~ ~GNATURE AND STAHP OF NOTARY OR I)EPUTY CLERK:
State of Flodda, County of Miami-Dade .':
Swam to and subscdbed/bef0re me ~-'
c---~nature of Public Notary - State of Florida
OFFICIAL NOTARY.~.AL
GLORIA M VALDIVIA
h~OTARY Pt,"BUC 5'rAT~ OF R.ORIDA ....
CC~ML~]ON NO. oo04~ Print, stamp or type name of Notary Public