Torben Riise/Culture in the Citym MIAMIBEACH
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 modificatwn 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 during the time
period of the entire decision-making process on such action, decision or recommendation that foneseeably 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
!n lobbying activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
//S t"-'
NAME OF LOBBYIST: LL
~U~fNr~ !;~ T~'i C
BUSINESS NAME AND ADDRESS
3e~~_ ~Sa-9s 9S
NUMBER:
I. LOBBYIST RETAINED BY11:
~u ~~~ r ~ % n 7~+2
NAME OF
FAX NUMBER:
/'
~ 33 /8~
~QW i
rji S P~t C4 I7'~t ~'.2 ~i! f~ C C~ ~y~ D!"Q
FMATI ~ /
/3 5 e o s cJ /d ~ ~l' f - G ~- S . ~1i1 i`a ~....,'' 7~L 3 3 ~ ~~
BUSINESS NAME AND ADDRESS (Number and Stmt) (City) (State) (gyp Cade)
~pS- ~Sa - 454 S 7`riid~~Ola ~fure~-n'fh eci~/y ~~
TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Secgon 2-482 (c)]
• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTI=REST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST: 1
0' /' b ~ rl ~iiJ t ~PJz a % ~c a ~ /~ Q,S e-
~ (Last) (First)
C / 7~y - /3~0 0 JW l~ ~ .ff C'r. t
(Number and Street) (City) ~
II. SPECIFIC LOBBY ISSUE:
(~ Y R rn~ a pp I ~~G 4
Issue to be bbbied (Describe i tail):
w~~J
III. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
S o~~cxr
/Title
of Individual
ll Name
A) Fu B) Arty Firrandal, Familial or Professbnal Relationship
~/
/
/
C/~TyG /1'i/41'Y'11 //C,C/~~ ^!' d NL-r
Cher<~ ~/~TZ ~HNGi~/
x ;'yY aY ~~ ~ r~ ~t j~ V1' ~ ~ ~. Y ~ 'f ~~~
City of Miami Beach, 1700 Convention Center Orive, Miami Beach, Florida 33139, www.miamibeachfl.gov
CITY CLERK Office
Tel: 305.673.741 1 ,Fax: 305.673.7254
LOBBYIST NAME:
CityClerk@miamibeachfl.gov
I understand that no later than October 1st of each xeor, 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) 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 City Clerk's Office of lobbyist withdrawal in writing.
~-
~„-~..,. ~ ~ o~
Signature: Date:
f~avisacl o2,Q4;200s