Steven Marin/Fla Graffiti Cntrl
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: cityderk@ci.miami-beach.f1.us
LOBBYIST REGISTRATION FORM
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(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
~ Check Box if an Amendment
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NAME OF LOBBYIST: (Last)
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(First)
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(Number and
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TELEPHONE NUMBER:
.30 < 97/37/ /
FAX NUMBER:
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EMAIL: (!t5 II'-
I. LOBBYIST RETAINED BY:
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NAME OF P N PAL/CUENT:
00
5
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 (c)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
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. UST ALL PERSoNs HOLDING, DIREffi Y OR INDIREd Y, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
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n. SPECFIC LOBBY ISSUE:
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Issue to be 100 ied (Descri e in etail):
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CITY AGENCIES/INDMDUALS TO BE LOBBIED:
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A) Full Name of Individual/Title
B) Relationship
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FLAr:V\l1:0R OTHER): I
A) lOBBYIST DISCLOSURE: J S 00 ~ Mu" JL R (b fat't1e f'
B) PRINOPAl'S DISCLOSURE (OF LOBBYIST COMPENSATION):
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1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach Citv Code Chaoter 2. Article VII. Division S
Thereof Entitled "Camoaian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaian Contributions BY Lobbvists On Procurement Issues":
Are YOU lobbyinG on a Dresent or DendinG bid for Goods. eauiDment or services. or on a Dresent
or DendinG award for GOods. eGUiDment or service? Yes No
2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach Citv Code Chaoter 2. Article VII Division 5
. thereof Entitled "Camoaian Finance Reform", Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaian Contributions BY LobbYists On Real Estate Deyelooment Issues":
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?
Yes No
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 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 as amended, and all
reporting requirements.
Signature of Lobbyist:
Form of lrentification
VI. LOBBYIST IDENTIFICATION:
IJ Produced ID
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
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Sig ture of P ic Notary - ,State of Florida
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Print, stamp or type name of Notary Public
./" FORCLERK'SUSEONLY I II
Registration: ~CEPTED [ ] REJECTED DATE: f '2.- P ! () ~
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If rejected, state reason: l ~(t) . ~
Registration fee paid: [ ] Yes [ ] No [ ] Cash k M~_----,
DATA ENTRY DATE: tf)?D .~ ENTERED BY~
2nd Revision 3/18/03 F:\CLER\HATL\lobbyists\registrationa03.doc
to
- CITY OF MIAMI BEACH
BIENNIAL LOBBYIST REGISTRATION
DATE REGISTERED:
, 2000
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LAST NAME,
.sle{)'e~
FIRST NAME,
LOBBYIST NAME
MIDDLE
BUSINESS NAME fi/l~ t'/,,- a.p\._l, - C::;-e~ ,/~
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(IF DIFFERENT FROM ABOVE)
BUSINESS PHONE t~ 7' "7. I ~ ~~
MAILING ADDRESS / ~3 D 9 ,c:::::c.....D J 9-4- c::..-"'"
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BUSINESS ADDRESS
I DO SOLEMNLY SWEAR THAT ALL FACTS CONTAINED IN THIS BIENNIAL REGISTRATION REPORT ARE TRUE AND
CORRECT, AND THAT I HAVE READ AND AM FAMIUAR WITH THE PROVISIONS OF MIAMI BEACH ORDINANCE 2000-
3243 (AMENDED 5/10/00), AND THE LOBBYIST REGISTRATION, REPORTING, AND WITHDRAWAL REQUIREMENTS
CONTAINED THEREIN. l\Y Pit OFRCIALNOTARYSEAL
o...t- <9<,~ IVETTE PINTO
1 c,: COMM1~ION NUMBER
... <( 00087452
71> ~ MY COMMISSION EXPIRES
OF f\.O FEB. l' .2006
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STATE OF FLORIDA, COUNTY OF MIAMI-DADE
SWORN TO ~SCRlBED BEFORE ~~~ .
METHIS J AYOF-4fkJl ,200 ~~ -'_
N UTYCL t~
BIENNIAL REGISTRATION FEE $125.00 PAID $ I
PAYABLE ON EACH EVEN-NUMBERED DATE
YEARS CASH
REC'D BY:
381 :l.:lO S,JI~J31:J HI:
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DEPUTY CLERK:
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