Gerald Schwartz/Glenna Norton
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained, whether paid or not, by a principal who seeks to encourage the passage, defeat
or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the
City Manager or any city board or committee; or any action, decision or recommendation of any city personnel defined in any
manner in this section, during the time period of the entire decision-making process on such action, decision or recommendation
that foreseeably will be heard or reviewed by the city commission, or a city board or committee. The term spedfically indudes the
principal as well as any employee engaged in lobbying activities. The term -Lobbyists" has specific exdusions. Please refer
to Ordinance 2004-3435.
NAME OF LOBBYIST:
SCHWPrR,T2
(Last)
GEl4ALD
(First)
(M.I)
"BeLo pF -to 9:,~ AP.12-
BUSINESS NAME AND ADDRESS (Number and Street) (City)
~OS'. ~7?' 1101 ~o~."73' 5~OS
TELEPHONE NUMBER: FAX NUMBER:
(State)
(Zip Code)
EMAIL:
I. LOBBYIST RETAINED BY:
GU1;NtvA '1-JORWN'
NAME OF PRINCIPAljCUENT:
'62 t..f2. D~ 11-f
BUSINESS NAME AND ADDRESS (Numbe
305". q7 5'. a.97c)
TELEPHONE NUMBER:
(State)
33/'-tO
(Zip Code)
EMAIL: (Optional)
Fill out this section If principal Is a Corporation, Partnership or Trust [5ection 2-482 (c))
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
. IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SP!:CIFIC LOBBY ISSUE:
~~0(d1~ ofs(~e ~'d~ restd~
Issue to be lobbied (Describe in detail):
Co 3C{1o ~Tt{ ~~
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER): "
.- b=
-256-
h
A) LOBBYIST DISCLOSURE: (Required)
.$ ? ."-0 ~ ~
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ..::::> -.::>'-
D Yes [I No: Are YOU reDresentinG a not-for-Drofit corDoration or entity without soecial comoensation or
reimbursement. Pursuant to Ordinance No. 2004-3435.
1)
Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaian Contributions Bv Lobbvists On Procurement Issues":
DYes D No:
Are YOU lobbyinG on a Dresent or oendinG bid for GOods. eGuiGment or services. or on a Dresent
or oendinG award for Goods. eGUiDment or service?
2)
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoai9n Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaian Contributions Bv Lobbvists On Real Estate Develooment Issues":
DYes 0 No:
Are YOU lobbyinG on a DendinG aDDlication for a DeyeloDment AGreement with the City or
aDDlication for chanGe of zoninG maD desiGnation or chanGe to the City's Future Land Use MaD?
V.
SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE ECEDING CALENDAR YE A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO ITURES OR CO N DU G THE
REPORTING PERIOD.
I do solemnly swear that all of the forego' g facts are true and correct and that I have read or am
familiar with the provisions aine~ in Section 2-482 iamj Beach City Code and all reporting
requirements. /' .'
PRINCIPAL IDENTIFICATION:
j;t
Signature of Lobbyist:
Signature of Principalj
VI.
o Produced ID
II Produced ID
Form of Identification
,v'P'ersOnaIlY known (Lobbyist)
Form of Identification
~onally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn tg ~~ subscribed befo~e me ,,/
This ~day of 1Pn I .20CJr-
.
State of Florida, County of Miami-Dade
Sworn nd subscribed befTe
IS day of /h~'lC. ,0051
Signatu ' f Public Notary - State of Florida
NotarizatiQ,~' .
; '/' ~ MARIA HANNAU
j {, Wi>' MY COMMISSION" DO 1_
" "'7 or l\~" EXPIRES: December 2, 200lI
\. ,.8:00-NOTARV FlNollry_&IlclndIng,lnc.
/' FOR CLER' SJ;.QNLY
Annual Registration fee: [ ] Yes [v1No Amount Paid .U/ MCR # 2&~i3' Date Paid
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: CLER\ALL\MARIA-M\LOBBYIST\lOBBYIST FORM 04
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