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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
Oty 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 specifically includes the
principal as well as any employee engaged in lobbying activities, The term "Lobbyists'" has specific exclusions. Please refer
to Ordinance 2004-3435.
I.(QolUf) .J:oannou Sofia
~BYIST: (last) (First) (M.I)
M TV ~ etwor/(,~ Lann Amcn~..::Ire, lilt LlneDI;' R.d., M ;arni Dcach ,FL 33/3'
BUSINESS NAME AND ADDRESS (Number and Street) (Oty) (State) (Zip Code)
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EMAIL:
I. LOBBYIST RETAINED BY:
_MTV t-Jctvvonc.t> LatTn\ A~~a:;),.::Ir1::; .
NAME OF PRINCIPAL/CUENT:
M1V Nctwo(~.l.atJn' Am~a:l,:In::" IIII Lu-Yan Ddi M IQmJ ~och. fL .331 ~Gj
BUSINESS NAME AND ADDRESS (Number and Street) (Oty) (State) (Zip Code)
~~q;) 53':).310C> '~05) :>35-6.~n
lEPHd'NE NUMBER: FAX NUMBER: (Optional)
MNLLl. com
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: Scot Mc5rfck:
. IDENTIFY All PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: VIC,CO(llI.:cnc.
II. SPECIFIC LOBBY ISSUE:
Alloa:Jtu.lrl of6rontMDnl~S: MI~m; ~ v;sitor i ConVO'ltu;o AuthorityTbtjri~Advorcernen1
Issue to be lobbied (Describe in detail): P-
I t'09("arn
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: V
A) Full Name of Individual/ntle
B) Any Financial, Familial or Professional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISQOSURE: (Required) --1J 0 C. ornp-J1~ot1nf)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). r-JO cornpc:n~')t..cn
Yes Q Are YOU reDresentinG a not-for-Drofit cOrDoration or entity without soecial comoensation or
reimbursement. Pursuant to Ordinance No. 2004-3435.
Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Campaign Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Campaign Contributions By Lobbyists On Procurement Issues":
1)
Yes ~
2)
Yes ~
v.
Are YOU lobbyinG on a Dresent or oendinG bid for Goods. eauiDment or services, or on a Dresent
or oendinG award for Goods, eGUiDment or service?
Pursuant to Ordinance No. 2003-3395 Amendina Miami Beach City Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaian Finance Reform". Via The Addition Of Code Section 2-490 Entitled "Prohibited
Campaign Contributions By Lobbyists On Real Estate Development Issues":
Are YOU lobbyinG on a oendinG 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?
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, AS WELL AS COMPENSATION
RECEIVED, IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENPITU R COMPENSATION DURING THE
REPORTING PERIOD. /
,,/
I do solemnly swear that all of the foregoing fa~13re true and correct and that I have read or am
familiar with the provisions contain ' Section 2-~82 of the Miami Beach City Code and all reporting
requirements.
Signature of Lobbyi
VI.
LOBBYIST IDENTIFICATION:
PRINCIPAL IDENTIFICATION:
Produced ID j.(..f 4~4"1~lo~t"o 1-104-0
Form of Identification
Produced IDV2 35015588270
Form of Identification
VII. SIGNATURE AND STAMP OF NOTARY:
Personally known (Lobbyist)
Personally known (Principal)
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This I ~ day of Sept . 2~
C ~::> "
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This 6-day of~. . 20M
C C "V "")-=:> ~~ _
Si nature of Public Notary - te of Florida
FOR CL~K'S USE ONLY C"__ I" _ I r-v- I
Annual Registration fee: [ ] Yes [ vrNo Amount Pai g~ .0::..) MCR # .;l7'd ~;rrl Date Paid ~
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F: CLER\ALL\MARIA-M\LOBBYIST\LOBBYIST FORM 04