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Affidavit Sunset Three 525 LLC .' , .' J i . . CITY OF MIAMI BEACH OFFICE OF THE CITY CLERK LOBBYIST REGISTRATION AFFIDAVIT lD - LOBBYIST SPECIFICALLY INCLUDES PRINCIPAL AS WELL AS ANY AGENT, OFFICER OR EMPLOYEE OF A PRINCIPAL. EACH PERSON WHO WITHDRAWS As A LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL." (1) Lobbyist Name Pardo Adrienn.. F. 3~T NAME, 579_068~IRST NAME HI. Business phone (-) Business Address 1221 Brickell Avenue, Miami, FL Zip 33131 (2) Sunset Three- 525, LLC Principal Retained By: Principal's Address 1100 Brickell Ave., #504, Miami. FE;ip 33131 (IF DIFFERENT FROM ABOVE) a. If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner, beneficiary, or interests. Robert Thorne 25% Bobbv Stecher 50% Frank Amedia 25% (3) Subject Matter (Describe in detail!) Lot split for property located at 1525 W. 24th Street (-::~ (/) ;;J , rJ :":-} :J ,.,"\ ;'~,) .,." ell , , ,~ .,.... .. -~ "- c' .. '.' rn --: '....! "" C) -' , ., (4) Identify each individual (Commissioners, Board, Committee, Authority member, or City staff) to be lobbied. NOtte p IQfIll\](N')bJ (J.,~J Elc.~\M\"1 S+q{'.( (5) The subject matter in number (3) above is to be considered at the meeting of: (Identify each entity or individual) o The City Commission o City Commission Subcommittee o City Staff o City Board or Committee o Personnel lit Identify Others Planning Board on 19 - on 19 - on , 19 - on 19 - on , 19 on 9/25 , xl&2ilill r , '. 0 (6) State the extent of any business, financial, familial, professional or other relationship which exists with any individual identified in number (4) above. None ON JULY 1 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE: CITY CLERK, A SIGNED STATEMENT UNDER OATH, LISTING ALL LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR THE PRECEDING CALENDAR YEAR. 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 2-48 of the Miami Beach City Code as amended, and all reporting requirements. ~ <~ Signature of Lobbyist: ~M P---.~ J ~ Adrienne F. Pardo ~ Personally known o Produced ID (lOENT I FY) ~ Did take an oath, or o Did not take an oath State of Florida, County of Dade Sworn to and subscribed before me this 2& day of ~2'e6 I I ~~~LRGO S L \NOTARY PU1!UC SfATEOF FLORIDA COMMIS.~ION NO. CC771348 '"r' ,~." ", <0 EXP. SEPT 17,2002 Notary: Prf~t~~~1:amp:-or Type 89 commissioned ****************************************************************************** Registration: ,rACCEPTED If rejected, state reason: o REJ ECTED Registration fee paid: tftes o No o Not For Profit Organization o Documentary Proof Attached MCR No. o Cash +heck 19 ENTERED BY DATA ENTRY DATE