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Robert Switkes ~ Oty of Miami Beach Office of the Oty Oerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: cityderk@d.miami-beach.f1.us LOBBYIST REGISTRATION FORM - (City of Miami Beaeh, Oty Code Chapter 2, Division 3, Section 2-481) IJ Check Box if an Amendment SWITKES NAME OF LOBBYIST: (Last) 407 LINCOLN ROAD, BUSINESS ADDRESS: (Number and Street) ROBERT (First) (M.l) DATE QUAUFlED AS LOBBYIST MIAMI BEACH, FLA 33139 (State) (Zip Code) (305) 534-4757 TELEPHONE NUMBER: PENTHOUSE S.E. (oty) (305) 538-5504 FAX NUMBER: EMAIL: I. LOBBYIST RETAINED BY: NAOMI WILZIG NAME OF PRlNQPAl./CUENT: 1901 BRINSON ROAD, #M4, LUTZ FLORIDA 33558 BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if prlndpalls a Corporation, Partnership or Trust [Section 2-482 (e)] · NAME OF CHIEF OFACER, PARTNER, OR BENEAOARY: NAOMI WILZIG · UST ALL PERSONS HOLDING, DIRECTlY OR INDIRECTlY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECFIC LOBBY ISSUE: LOCATION OF MUSEUM Issue to be lobbied (Describe in detail): In. CITY AGENCES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Relationship PLANNING and ZONING DEPARTMENT PLANNING BOARD CITY COMMISSION IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLA T RA TE OR OTHER): A) LOBBYIST DISClOSURE: $450 _ 00 em hour B) PRINCIPAL'S DISCLOSURE {OF LOBBYIST COMPENSATION}: $450.00 an hour 1) 2) Pursuant to Ordinance No. 2003-3395 Amendinc Miami Beach City Code Chaoter 2. Article VII Division 5 ~;~~~;~~;;~~~~~~~;~~~~~;i:~P? V. SIGNATURE UNDER OATH: ON OCTOBER 1ST 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 fa re true and correct and that I have read or am familiar with the provisions contained in Se on 2-48 of the Miami Beach City Code as amended, and all reporting requirements. / Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: IJ Produced 10 ~allY Known Form of Identification VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: State of Florida, County of Miami-Dade Sworn to and subscribed before me This day of . 2003. ~ f Florida o. cc 901893 Public FOR CLERK'S USE ONLY Registration: N ACCEPTED If rejected, state reason: Registration fee paid: ~Yes [ ) No DATA ENlRY DATE: fS J ?O , [ ) REJECTED DATE: g-t1Q~O'3 [ ) Cash .k:J Check MCR # .2003 ENTERED BY: 2.~j3() L 2nd Revision 3/18/03 HATL \Lobbyists\registrationa03.doc