BFI
10/22/2003 12:13
3055385578
ROSE~I SWITKES ET AL
PAGE 02/02
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City of Miami Beach Office of the City Clerk
1700 COIl\/I!ntion Center Drive, Miami Beach, Fl33139
Em~lI: cltyderlc@d.miami-beach.n.us
lOBBYIST REGISTRATION FORM
(Oty of Miami Beac", Oty Code Chapter 2, DiviSion 3, Section 2-481)
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TELEPflONE NOMBER: FAX NUMBER:
'EMAIl:
t. 757!ED BY:
NAME OF PRlNClPAUCUE :
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BUSINESS ADDRESS: (Number and Street) (City)
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(State)
.7 J / r..r L-
(Zip Code)
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FAX NUMBER: (OptIO[lal)
!:MAIL: (Optional)
, ,
Fill Dut this section if principal Is a Corporation, Partnership or Trust [Section 2-482 (c)]
. NAME OF CHIEF OFF1CER, PARTNER, OR. BENEFIClARY:~""''''.:! /"'"],.J-I e, k1 rb-7/1-
//11' J1'" J? ,"'f)~
UST AlL PERSONS HOLDING, DlRECT1. Y OR INDIRECT1. Y, A 5% OR MORE OWNERSHIP INTCREST IN SUCH
CORPORATION, PARlNERSHIP OR TRUST:
II_ SPECflC ~BY ISSUE: ('.---.
tJ rJ vii Uf!-.//,P C3J LI O<..t6PJ .
Issue to be lobbied (Describe In detail):
III. CTY -,GENOES/INOMDUALS TO BE lOBBIED:
A} Full Name of Individual/Title
B) Relationship
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10/22/2003 12: 13 3855385578 ROSEt~ SI,HTKES ET AL PAGE 81/ 82
rJ. DlSCLO~RE OF TERMS A.I\IO AHOUNTS OF LOBBYIST COMPEP/.SATION (DlSCLOSI: WHETHER. HOURL Y,
FLA T RATE OR OTHER). l'
A) LOBBYIST DISClOSURE: ~:.?;~ ;;- 'I'''' I~""" ,.h -,,'f.; Y1::: ,,{;.''//t ,,~v
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1"
BJ PRINCIPAL'S DLSCLOSURE (OF LOBBYIST COMPENSATION); / .?"ce)
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1) Pursuant to Ordinance No, 2003-3393 Amendina Miami Beach City Code ChaDt1!r 2 Article VII Division 5
Thereof Entitled -Camoalon finance Reform" Via The Addition Of Code Section 2-488 Entitled ~Prohibited
Camoaion Contributions By lobbyists On Procur~ment rs~ues":
:~::I~::::~d 0;:': 9~:~:.n~:~i::;ed~~:rb~~~~;~e~a~;~~l!nt ol'sen,h:es. or on iI Dresent
2) Pursuant to Ordinance No 2003-3395 AmendinQ Miami Beach City Code Chaoter 2. Article VII Division 5
thereof Entitled -(.amca;Qn Finance Reform" Via The Addition Of Code Section 2.490 Entitled "Prohibited
Camoalan Contributions Bv lobbvists On Real Estate Develooment Issues":
Arr YOU lobbvin9 on it Dendina aDoliqtion for it DeveloDment Aqreement with the City or
ilDDllation for chanae of zonina maD desianation or chanae to the City's Future lilnd Use MilD'
DYes M No
V. SIGNATURE UNDER OATH:
ON OCTOBER I'" OF EACH YEAR, EACH lOBBYIST SHALL SUBMIT TO THE em ClEklC A SIGNED
STATEMENT UNDER OATH, USllNG LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR
THE PRECEDJNG CALENDAR YEAR.
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions contained in Section 2-482 of the Miami Beach City Code CIS amended, and all
reporting reqUirements..~
Signature of lobbyist: .~~~ .
. )'pt ~j..-.
Signature of Principal/ClientJ~~~
VI. LO.BYIST IDEKTlFICA TION:
Q Produced 10
o Personally Known
Form of Identification
VII. SIGNATURE AND STAMP OF NOT AAY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This 'i ,') day of ('rti'" .\\,,1,. 2003.
tary Public
R>!glstTibol'l: ~~PTED
If rejected. state reason: /.
Registration ree paid: t-rYes [ ] No
OATA ENTRY DATE: t ()- Lt.
FOR CLERK'S USE ONLY
] REJECTED DATE:! D "-I b.... (0
2nd Revision 3/1 B/03
[ ] Cash [ ] Check MeR.
. 2003 ENTERED B"':~
F :\ClfR\HA Tl \lobbyists\registrationa03 .doc
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