Aleksandar Stojanovic/Aleksander Stojanovicm MIAMBEACH
City of Miami Beach Office of the City Clerk
17Q0 Convention Center Drive, Miami Beach, FL 33139
LOBBYIST REGISTRATIOrT 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 derision of any commissioner; any action, ded~on, recommendation of the
Gty Manager or any city board or committee; or any action, decision or recommendation of arty dty personnel during the time
period of the entire decision-making process on such action, deasion 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.
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NAME OF LOBBYIST: (Last) (First) (M:~ )
IE AND ADDRESS
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I. LOBBYIST RETAINED BY:
ember and Street) (City) (State)
(Zip
33~3~
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (ap coae)
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 BENEFICIARY:
FtIFI~S~-Iup~ ~T°JA-~- o~: C
IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH.
CORPORATION, PARTNERSHIP OR TRUST: ~°O ~~ SZ
A LIp'CI N p ~ (~ 2 ( ljrc-t~-S^-~-lo an Sri .~,~ ~: c M~~ ¢~
II. SPECIFIC LOBBY ISSUE:
Issue to be lobbied (Describe in detail):
III. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Any Fnancial, Familial or Professional Relationship
~~ ~ ~
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLAT RATE OR OTHER
A) LOBBYIST DISCLOSURE: (Required) ~ ~'~ \
B) PRINCIPAL`S DISCLOSURE (OF LOBBYIST COMPENSATION): (Required). ~ ~' ~~
The following information must be answered:
i} Pursuant to Miami Beach City Code Section 2.488 Entitled "Prohibited Campaign Contributions 8y Lobbyists
On Procurement Issues":
present or pending award for goods equipment or service
2} Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists On Real
Estate Development Issues":
dYe^~io Are you lobbying on a nendindgunfication for a DevelQpme~rt Aareemen~ with the City or
application for change of zoning map dac7enatine nr change t~ thE+ c~tv~a isuture Land Use
Mau?
3) Pursuant to Miami Beach City Code 2-484 (h) Any person (except those exempt from the definition of
'~IobbyisY' as set forth in Section 2-481 above) who only appears as a representative of anot-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..
^ Yes ~ho• Are you representing anot-for-profit corporation or entity without suecaal comcensation
or reimbursement. .
V. SIGNATURE UNDER OATH:
ON OCTOBER 1~ OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING 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 O~ COMPENSATION DURING THE
REPORTING PERIOD. _ ! 1 1
Signature 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.
Signature of Lobbyist:
Signature of Principal/C
VI. LOBBYIST IDENTIFICATION:
IroducedID
Form of Identification
u Personally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of Florida, County of Miami-Dade
Sworn to a~ sub ~ ' HE~~~
This daV, ~•' ~~ •~~ ItjN # DD 626373
~~h ~"4P ;; EXPIRES: May 3, 2011
I~ ~' Bonded Thru Notary Pubkc Underwiitera
Sighatureubl
Notariza on of Lobbyist's signature
PRINCIPAL IDENTIFICATION:
i--~Brbduced ID ~ (i~-~
Form of Identification
u Personalty known (Principal)
,.;~~•";; KEFlRY HER
='i :*5 MY COMMISSION # DD 626373
State of Flor ~~;,, :o~~d~s 2011
Sworn ands ", ~ ~ ovary °- ~"da""i`e'e
This ~?day of . Z0~
Signature of Pt~51iE I~istaxy
Notarization of Principal's
J~ G`iQ f y0 ff0 ~ R CLERK'S USE ONLY _
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