Mathew Amster/Miami Beach Community Kollel, Inc.
m. MIAMI BEACH
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 dty personnel 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.
Amster
Matthew
NAME OF LOBBYIST:
(Last)
(Rrst)
(M.1)
Bercaw & Radell, P.A. 200 South Biscayne Blvd., suite 850
BUSINESS NAME AND ADDRESS (Number and Street) (aty)
Miami, Rorida 33131
(State)
(Zip Code)
(305) 377-6220
TELEPHONE NUMBER:
(305) 377-6236
FAX NUMBER:
mamster@brzoninglaw.com
EMAIL:
I. LOBBYIST RETAINED BY:
Miami Beach Community Kollel, Inc.
NAME OF PRINCIPAL/CUENT:
Miami Beach Community Kollel. Inc.
BUSINESS NAME AND ADDRESS
3767 Chase Avenue
(Number and Street)
Miami Beach
(City)
FL
(State)
33140
(Zip Code)
(305) 532-8991
TELEPHONE NUMBER:
(305) 532-8925
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, PARlNER, OR BENEAOARY: Rabbi Yaacov Gross
. IDENTIFY ALL PERSONS HOLDING, DIRECTlY OR INDIRECTlY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARlNERSHIP OR mUST:
II. SPECIFIC LOBBY ISSUE:
Application for variance to Board of Adjustment (BOA).
Issue to be lobbied (Describe in detail):
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III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Financial, Familial or Professional Relationship
Jorge Gomez None
Richard Lorber None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLA T RA TE OR OTHER):
. A) LOBBYIST DISCLOSURE: (Required) $155.00 oer hour
B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). $155.00 oer hour
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 X No: Are YOU lobbyina on a present or pendina bid for aoods. eauipment or services. or on a
present or pendina award for aoods. eauipment or service?
2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
DYes X No: Are YOU lobbyina on a pendina application for a Development Aareement with the City or
application for change of zonina map desianation or change to the City's Future land Use
Map?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"lobbyist" as set forth in Section 2-481 above) who only appears as a representative of a not-far-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..
D Yes X No: Are YOU representina a not-for-profit corporation or entity without special compensation
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 EXPENDInJRES, 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 EXPENDInJRES OR COMPENSATION DURING THE
REPORTING PfR1OD. ~_~ ~
tA
ignature of Lobbyist
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 and all reporting
requirements.
ignature of Lobbyist:
ignature of Principal/Client:
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Form of Identification
Form of Identification
~ Personally known (Prin - . ""'" V. MENDEZ
. ~'f'{""A.~:' MY COMMISSION # DO 285215
1.1~~.~i.r! EXPIRES: January 27, 2008
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State of Aorida, County of iami-Dade
Sworn and subscribed before me N "
This \5\':D>-day of OJ!{)
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Personally known (Lobbyist)
SIGNATURE AND STAMP OF NOTARY:
Annual Registration fee: ~
] No
FOR CLE2K'S USE ONLY n &l6 c;: .
Amount Paid .t;;i), V () MCR # ,L- :f' tf Date Paid