Robert Goodman/Frank Russo, Jr. Global SpectrumApr 03 08 04:32p Frank E. Russo, Jr.
m MIAMIBEACH
8606570761 p.2
City of Miami Beach (3ffiice of the City Clerk
17'fl0 Convention Center brave, Miami Beach FL 33139
LOSSYi5T REGISTRATION FO1ZM
Lobbyist means all persons mnpioyed or retafiEd, wlied~er paid or not, by a principal who seeks to eaicnurage the passage, deFeat
or modification of any advance, resdutbn. adlon or derision of aM- oo~nLasioner, any sd~ dec~lon, n~minendatlon of tt+e
pry Manager or any dty board ar cotnmlttee; er any adton, dedsien or recommendatbn of any dly peisatrnel dmirlg the tlme
period of the entlro decision-making Process on surh action, derision a remmmendatlon That foreserably will be heard or reviewed
by the dry commtsslon, or a dh hoard or aomrrattee. The teem spedtlcaly bxlud tltie prlr,dp01 as well as any employee ~9as7~
!r~ tobhying aCtlvltles. The tat7n't-ubbl-isls" has sPeciFa extlctstons. Pleasa r~fer to Ordtnaesae 20D4-34tl5.
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LDbBYZST p1ETAiNF~ taY:
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ouk thLs se on If peilrtdpai is a Cgrporation, Partnership or Trust [Section 2.482 ({3]
• NAME OF CHIEF OffICBi, PAR'iNER, Ott BteNEFICIAR.Y:
IDENTIFY ALL pEIZSONS tiDIDING,, OIRECI't_Y OR INI]IIAECRY, A S'Ye OR MORE pYVNEitSFiiP IIV7'EItEST UV SUCH
+ODaPORATION, PARTTIEILSFtIP OPl TRIJ,Si':
LI. SPEf,:ICrICLOBBYISStlE:
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Issue to be cobbled (i~urlbe h detaH):
tu. G[TY AGENCTt:SjINDMDUALS TO BE LOBBIED:
!1) Full Name of IndiWdualfTitla ti) Any Financial, Familiar or Profossiw~al Relationship
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Apr 03 08 04:32p Frank E. Russo, Jr. 8606570761 p.3
IV. DISCLO5URB OF "rRftMS ANO AMOUNTS O>F LOBBYISTCCMPENSAI'LON (DISCLOSE WltEfHER Hp!!liLY,
lKATR.irEQR OTJYfRf .
A~ L08HYI5T diSCLOSiJRE: (Required) 1(Q.J
to r~
B'j PRINQPAL'S pISClOSUI;I: KOF L4b6YISr COMPENSATION): (~urrad).~
The following Infvtmation must be atfswered:
i) Pursuant t0 Mtarrii Beach City Code Section z-A88 Entitled "Prohibited campaign ContribuEions By Lobbyists
On Procurement Issues":
2) Pursuant to N+Uaml Beach City CAde 2-490 Entlkled "Prohibited Campaign Contributions By lebbylsls On Real
Estate Develvpment!'ssues":
MapT
3) Pursuant to Miami Beach Qty Cade 2-484 (h) Any person (except those exempt from the defiMtlon cf
"lobbyist" as set forth In 5ettlorl 248i. above) who aaly appears as a tepresentadve of a noh•for~pro8t
corporat)vn or entity without spedal mmpensation or reimbursement far the appearance, whether direct, or
indirect, to express support of or opposition ko any item, shall regLsber with the clerk as requUed by this
section but, snail not be required bo pay any regtshabion Pees..
y. SIGNATURE UNDBR QJ-'rH:
ON OCTOBER 1~ OF EACH YEA1>;- EACH LAS>llYIST SI~tALi- St?BM3T TO THE CITY CI.ERI(A SIGNED
STATEMENT UNDER dATHr LISTING f.0$l3YING EXpENb1TUR65, AS WPLL AS COMp~SATiDN
REt~Vl=b, IN THI; C3TY OI' MIAMT BIEACH FOR 7T{ P[eECEDING YEAR. A STATEMENT'
SHALL BE EIt,ED EVEN IF TT4f?RE HAVE BEEN HO 1~DITUR~ ~~~1 b~~E
ItEpORTING pBR3OD.
-v-T glg~ha~ o~(L15bby1st
I do solemnly swear that a!i of tfie foregoln are true and wrrect and that 1 have read or am
familiar With the provisb~ cot~l-ted in am th QtY Code and a!I reporting
requirements. (~
Signature of Lobbyl5t:
Signature of Prlndpal/Cl}en7~
yI, LoB8YI5TIDt:NiiFTGItiGN:
'~ produced ID ~ ~
Form of IdentiHcatbn
PRINCIPAL
^ Produced ID
Form of Ydentlfk:adon
^ Personally known (Lobbyist)
Vii. SIGNATURE ANb STAMP OF NOTARY:
Stake oP Florida, County of Miami-bade
Swom.tQand subscr~ed be me~Q~
This 171 day of
of
d Personally known (PHnclpal)
~.,p~r y~H•tMi
state of ,
sworn a subs~rt be, re me
Thy ~ y oP ao~
~/,z _-
Signature afi Public Nary -State of Fonda
lYotatixatioe of prl:tcipal's signature
FOR CLERIC'S VSfe ONLY
Annual Re91st*adon Fee: [ 7 Yes j ) ~ Nnount Paid ~' MCR
Lobbyist Replstragon Form received and verlfled by:
F:~CLERt'~kAI1~MARTA-M',LobbylstlLOBBYIST FORM 05,doc ~,~
~/ Data Palo ~ O a
Revised
EiE'd t+LL'ON l~d£0:Z 800Z'SL'2JdW
JJ + ;~ +w
City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miomibeachfl.gov
CITY CLERK Office
Tel: 305.673.741 1 ,Fax: 305.673.7254
LOBBYIST NAME:
~~e~-~
C ilyClerk@miam ibeachN.gov
~O~G~~ ~
I understand that no later than October 1st of each year, I must file the following
forms, pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's
Office for all active lobbying issues.
1 J Lobbyist Expenditure Form
2) Disclosure Form
Failure to file these forms on a timely basis will result in my name being transmitted to the
Miami-Dade County Commission on Ethics and for code violation evaluation.
In addition, once an issue I have registered to lobby on has been resolved, I am required
to immediately notify the C,rty Cl~t'~ Offic j o~obbyist withdrawal in writing.
Signature:
I~~~~~sa~a o~roal2oos
Date:
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