Chabab Lubavitch of Venetian
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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 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. .
ROSEN
HAROLD
,
NAME OF LOBBYIstr:
407 LINCOLN ROAD
BUSINESS NAME AND ADDRESS
(Last)
PENTHOUSE S.E.
(First)
MIAMI BEACH, FL 33139
(M.I)
(305) 534-4757
TELEPHONE NUMBER:
(Number and Street) (City)
(305).538-5504
FAX NUMBER:
(State)
(Zip Code)
EMAIL:
I.. LOBBYIST RETAINED BY:
CHABAB LUBAVITCH OF VENETIAN CAUSEWAY AND SURROUNDING ISLANDS, INC.
NAME OF PRINOPAljCUENT:
14 FARREY LANE, DILIDO ISLAND, FLORIDA 33139
(Number and Street)
(City)
(State)
(Zip Code)
BUSINESS NAME AND ADDRESS
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Section 2-482 {c)l
. NAME OF CHIEF OFACER, PARTNER, OR BENEFICIARY:
RABBI ABRAHAM MANN
. IDENTIFY ALL PERSONS HOLDING, DIRECfL Y OR INDIRECfL Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
CONDITIONAL USE
Issue to be lobbied (Describe in detail):
IY. f="0\(re..11o.0v
III.
CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
.. II.". ,......~...1.""'....,
He.""'"...''' A. 1.
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A) Full Name of Individual/Title , B) Any Financial, Famillill or PrOt$io",il Relatlo"shlp:
PLANNING & ZONNING DEPARTMENT
PLANNING BOARD
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL~.
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required)
B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required).
$2,500.00
$2,500.00
1) Pursuant to Ordinanc No. 2003-3393 Amendin Miami Beach Ci Code Cha ter 2 Article VII Division 5
Thereof Entitled \\ m ai n Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibite
Camoaian Contributions By LobbYists On Procurement Issues";
ervices or on a res nt
2) 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
Camoaign Contributions By LobbYists On Real Estate Develooment Issues":
oYes ~ No:
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CIlY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION
RECEIVED, IN THE CIlY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. A STATEMENT
SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES 0 ENSATION DURING THE
REPORTING PERIOD.
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Signature of Principal/Client: ~ ,>';:___
Signature of Lobbyist:
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VI. LOBBYIST IDENTIFICATION:
o Produced 10
PRINCIPAL IDENTIFICATION:
~duced1O FtJ(
Form of Identification
Form of Identification
~~rsOnaIlY known (LobbYi~t)
o Personally known (Principal)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
SwornADd SUbscri~e me 05
This .2:C]day of _ , 20_ ~
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Signature O!.2JJ~w;'~Q~ ...9tm~.o :Florida
Notif1Yll10n ~ I ' . tla~re
. ~""ff"1It 008 .
: ~ ~'t I:':v.u1'88 1/1312 :
: liiIf,'<......... -4254:
: ~. '.:, ~ Bonded thru (800)432 :
. ~~ '.P,; ... tary A.<;sn., InC I
:, '.;~OF~~'{' F\onda 1'...0.................
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Annual Registration fee:.. [ ~'NO A
Lobbyist Registration Form received and verified by:
Revised 02/10/04 F'
, U ONLY ~ . .. / I
: MeR it, 71 ~ 22 Date Paid <l 2'1 uJ'
MARIA-M\LOBBYIS1\LOBBYIST FORM 04 / /