Jack Luft/Maefield Holdings LLC
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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 dty 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 dty commission, or a dty board or
committee. The term specifically indudes the principal as well as any employee engaged in lobbying activities. The tenn
-Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
NAME OF LOBBYIST:
Luff
(Last)
Jack
(First)
(M.I.) DATE QUALIFIED AS LOBBYIST
1717 Windward Wav
BUSINESS ADDRESS: (Number and Street)
Sanibellsland
(City)
33957
(Zip Code)
FL
(State)
305-945-3636
TELEPHONE NUMBER:
305-945-3737
FAX NUMBER:
EMAIL:
I.
LOBBYIST RETAINED BY:
Maefield Holdinas LLC
NAME OF PRINCIPAUCLlENT:
1526 Blueiav Wav
BUSINESS ADDRESS: (Number and Street)
Los Anaeles
(City)
90069
(Zip Code)
California
(State)
310-360-7712
TELEPHONE NUMBER:
310-360-7711
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section If principal Is a Corporation, Partnership, or Trust [Section 2-482 (c)]
? NAME OF CHIEF OFFICER, PARTNER OF BENEFICIARY: Mark Siffin
? LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST
IN SUCH CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Desian Review Board Aooroval
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Al Full Name of IndlvlduallTltle BI Relationship
JOllie Gomez, Director None
MercY Lamazares None
Richard Lorber None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) 5150.00
B) PRINClPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). 5150.00
o Yes)\ No: Are YOU reDresentlnG a not-fo....DrofIt coraoratlon or entity without soedal comoensatlon or
reimbursement. Pursuant to Ordinance No. 2004-3435. '
1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach aty Code Chaoter 2. Artide VII. Division 5
Thereof Entitled "Camoaian Rnance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaian Contributions BY Lobbvists On Procurement Issues":
o Yes X No: Are YOU lobbYInG on a Dresent or oendlnG bid for Goods. eaulDment or services. or on a Dresent
or oendinG award for GOods. eaulDment or service?
2) Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Artide 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 Develooment Issues":
nYes ~o: Are YOU 10bbvlnG on a oendlnG aDDllcatlon for a DeveloDment AGreement with the City or
J aDDllcatlon 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 EXPEND AS W LL AS COMPENSATION RECEIVED,
IN THE CITY OF MIAMI BEACH FOR THE PRECEDING L YEA . A STATEMENT SHALL BE FILED
EVEN IF THERE HAVE BEEN NO EXPENDITURES OR T10N URlNG THE REPORTING PERIOD.
Signature of Lobbyist:
Form of Identification
nON:
~oducedID In(!!r'(}I7t:f Dru. Cc-
Form of Identification
I do solemnly swear that all of the foregoin
am familiar with the provision tained .n
reporting requirements.
VI.
i~uced ID
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Ignature of Public Notary - State of Florida
otarization of Lobbyist's signature
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Iff I si
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Personally known (Lobbyist)
SIGNATURE AND STAMP OF NOTARY:
o Personally known (Principal)
FOR CLERK'S USE ONLY
Annual Registration fee: [~ [ ] No Amount Paid" d5. a?-NCR # c2( ~?SlJ Date Paid ,)-1 d' -@
Lobbyist Registration Form received and verified by: ~./
Revised 02/10/04 F: CLER\ALL\MARIA-M\LOBBYISi\LOBBYIST FORM 04
1 First Revision - 05-17-02