Maribel Cabrera/Gen. Conf. SDA
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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, dedsion or recommendation of any dty personnel during the time
period of the entire decision-making process on such action, dedsion or recommendation that foreseeably will be heard or reviewed
by the dty commission, or a city board or committee. The term specifically indudes the prindpal as well as any employee engaged
in lobbying activities. The term -Lobbyists- has specific exclusions. Please refer to Ordinance 2004-3435.
Cabrera Maribel
NAME OF LOBBYIST: (Last) (First)
Miami Beach Spanish SDA' Church 7801 Carlyle
BUSINESS NAME AND ADDRESS (Number and Street) (oty)
(M.1)
Avenue, Miami Beach, FL
(State) (Zip Code)
33141
(305) 835-7540
TELEPHONE NUMBER:
(786) 287-7989
fDQlKDlIlIEJt: Cellular
EMAIL:
I. LOBBYIST RETAINED BY:
General Conference of SDA
NAME OF PRINOPAL/CUENT:
655 N. Wymore Road
BUSINESS NAME AND ADDRESS
(407) 644-5000
Winter Park
(Number and Street) (City)
(407) 644-7550
FL
32789-1715
(Zip Code)
(State)
floridaconference. com
TELEPHONE NUMBER:
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, OR BENEFIOARY:
N/A
. IDfNTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC LOBBY ISSUE:
Request for Conditional Use Permit. 18D I
Issue to be lobbied (Describe in detail):
~
ID. CI1Y AGENClES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Any Financial, Familial or Professional Relationship
None
... '.~.n ........k __......._....___....."'"...~~.,,",,.""_
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSA110N (DISCLOSE WHETHER HOURLY,
FLA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE: (Required) None - No cash or cash equivalent compensation.
B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). None
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled "Prohibited Campaign Contributions By Lobbyists
On Procurement Issues":
D Yes iI No: Are YOU lobbyinG on a Dresent or aendinG bid for GOOds. eauiDment or services. or on a
Dresent or aendinG award for Goods. eauiDment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes IXNo: Are you lobbyinG on a aendinG aDDlication for a DeyeloDment AGreement with the CitY or
aDDlication for chanae of zoninG maD desiGnation or chanae to the Citv's FubJre Land Use
MaD?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"Iobbyisr' as set forth in Section 2-481 above) who only appears as a representative of a not-for-profit
corporation or entity without special compensation or reimbursement for the appearance, whether direct, or
indirect, to express support of or opposition to any item, shall register with the clerk as required by this
section but, shall not be required to pay any registration fees..
rXYes D No: Are you reDresentinG a not-for-Drafit comoration or entitY without SDeCial comaensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTlNG 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 EXPENDITURES OR COMPENSATION DURING THE
REPORTING PERIOD.
I do solemnly swear that all of the foregoing facts are tr e and correct and that I have read or am
familiar with the provisions contained in Section 2-482 of the Miami Beach City Code and all reporting
requirements. ~
Signature of Lobbyist: .. ~
Signature of PrIndpal/Oient: -
VI.
LOBBYIST IDEN11F1CA110N:
PRINCIPAL IDENTIFICATION:
nroduced 10 d/~? G tfO ~ 2 7J7-1
Form of IdentifICation
(tJ1" Maurilia Martinez Rego
Personally known. ..' ~ommission 00279660
, . II
SIGNATURE AND~~Pxar)j6'fl'R~ 2008
o Produced 10
Form of Identification
::J Personally known (Principal)
VII.
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of 20ejT
State of Florida, County of Miami-Dade
Sworn and subscribed before me
This _day of . 20_
Signature of Public Notary - State of Florida
Notarization of Princi I's signature
FOR CLE 's USE ONL!1\R' '
Annual Registration fee: [ Yes [ ] No Amount P d - - MCR #
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\MARIA-M\Lobbyist\LOBBYIST fORM OS.doc
Revised 12/08/04
FIRE&POLICE-PENSIDN
F a.>~ : 4076447438
ID:3056737126
Sep 7 2005 15:40
P.03
SEP 07'05
14:31 No.003 P.03
IV. D1SCLOIUR! DP TlR"' ANO ",..O\lNlS OF LOa8YIST COM,MSAllOt.1 (DIICLOII! WHETHlill ~L Y,
1U' RA'" DR "".tdt
A) LOt!In1ST DlICLOll.lltt: CRaqutnd) q..~tone .. No c~u~l1 J!r-. cash c(J\livale!!.~,,~!>~~n.QQt1on '-
8) "'INCIPAL~ DlSClOSURf (OF U)ABVTST COMPENSATION): (Ae....red)._...... .' ~ onft .....---
TIM following Informatlon mud: be IIn.werecs~
1) Pursuanllo Miami Boach City Code Section ~-4I1 Entitled "Prohibited c"m08lgn COntrtbutlons BV lobbyists
0., Procurement IsGueG"!
I.l YH. "VJ Mill "ra WI" lobbytnv on a D.....nt Dr _n~~"D bid far ~ ~uIDm.nt Dr M1rvk:aI~ Dr' Dft ·
v~nt Dr ,.ndln, award for 906dL .."IDlftent or Mrvlc;:e?
Pu~nt to Miami BSleh CIty Cede 2-490 En\l1Jed -Prohlbtted CampDI9n t.ontribut1ons ey lobbyists On A.eal
~ Development leeUM":
0"" ~N.J ~=-::.a:::~ .,."dinG aDDlIcMksI'l far. ...,.,oDlftontAanacunont WIth 1ft. CIW or
.______ . ~f ~;;iO; map d.llIJn-.Hon or duI~ tit It", r:a.-" Futuril ~nd UaII
t!I&l1
~)
3)
pura;u,nt to MUimi Belch CRy Codl 2-484 (h) My person {~t those exempt from the definition d
"Iobbyi.- ai ~ 'orth m ~(;t10l'! 2-491 IOOvO') who only a~peJ" U " ~re$entltlv~ Qf It n~for.prof1t
corpomtlDn or r:mtlly without spedel compensation or reimbursement for the ~ppc~nlnceJ whether clrt'tt, or
In(lrect, to elt'pre'" support or or opposftlon ro atlV ltam, sMll regbter with tf1e deft as required bV this
settion but, shill! not be required to pay any registration ree8"
rxVH 0 Hal AN veu ,.NlMntlna a n&t.fer-araftt corDORtt.n or ."tttv WJtMIlt slWPl.. ~1II...natiaft
Ar .eI",bu~ment. l
w. ....Allie UNDBl OA11tJ
ON ocrol!R 1,,,. or I~C:" '1M, ~(.. lrQaavI$T 'HALL SUIMIT TO TMI CITY ClERK A SIGNeD
STATI!MI!NT UND!R OATH, U5nNG LO'.YI"G EXPENOnuUS, AS WILL AS COMH!NSATlON
R!l21WD, IN THI! CITY 0' MIAMI a!ACM mR TN! llReC!DING CALeNDAR ftAR.. A 5TATI!N!NT
SHALL Ie PlLID IV!" IP TH!RE HAvt BEeN NO IKflENDITURIS OR COMPENSATION DURING THE
JU!PORTINfi PIRIOO.
I do sotemnrv swear that ell of the fo~ng facts are t e and correct and that I have read or 11m
famtllar with the provl $I on $ cont,lned In 5ectIOf'\ 2-482 or the MI,ml ~ch Oty Code ilnd all reportlng
requ'rements. ~..~
SIgnature of LDbbyl;t: ~
S1glllltU", of PIlncipll/CUent: -.- -. - ._
VI. LO..YIIT IDlNTJPlCAnON& PRINCIPAL IDINftPleAnON:
nrO<lU~d It) ~ I~' !5. f1~ ~...I j ! Produced 10
Form of Identlne.atlon Form of IdentlflCl!ltion
~~ Maun.w ....rttMr ~
I I PersoMII'f known . ~ommlUI6I\ D02l8UO
VII. SlfiNATURi AN~". ;\mt6YXlf.1ClO8
---'FORCl& 7iUis ONL~"
AI1nlJ~1 Ragk1J'3tlDn IU! [ Y811 [ ) No Amount" . ~ _ MOl II-
LcYlilV~ fl~ti~ F()nt'1 tirid I^d yried by:
F: \Q.EP.\fALl \MAAIA-M\Lobbybt\LOeaVIST fORM OS.d
~ U/08/04