The Kabbalah Centre
.
lD
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CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
1700 Convention Center Drive
Miami Beach, FL 33139
cityclerklCilci. miami-beach. f1, us
AFFIDAVIT
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 ANY CITY BOARD OR COMMmEE; OR ANY ACTION, DEOSION OR RECOMMENDATION
OF ANY PERSONNEL DEFINED IN ANY MANNER IN THIS SECTION, DURING THE TIME PERIOD OF THE ENTIRE DEOSION-MAKlNG
PROCESS ON SUCH ACTION, DECISION OR RECOMMENDATION THAT FORESEEABLY WILL BE HEARD OR REVIEWED BY THE CITY
COMMISSION, OR A CITY BOARD OR COMMmEE. THE TERM SPECIFICALLY INCLUDES THE PRINOPAL AS WELL AS ANY AGENT,
ATTORNEY, OFFICER OR EMPLOYEE OF A PRINCIPAL, REGARDLESS OF WHETHER SUCH LOBBYING ACTIvmES FALL WITHIN THE
NORMAL SCOPE OF EMPLOYMENT OF SUCH AGENT, ATTORNEY, OFFICER OR EMPLOYEE. EACH PERSON WHO WITHDRAWS AS A
LOBBYIST IS REQUIRED TO FILE A "CERTIFICATE OF WITHDRAWAL"
Ser Lillian
1)
Lobbyist Name:
Last Name
First Name
A.
Middle Initial
Business Phone ~ 358-6300 Message Phone ~ 347-7375
Business Name and Address: Shutts & ~ LLP
1500 Miami Center, 201 South Biscayne Boulevard Miami FL
33131
No. Street Suite
lseriilShutts law. cern
Email Address:
City
State
Zip Code
2)
Principal Retained by:
5401 CbllinsAvenue,
If different from above
Miami Beach
The Kobhalah Centre, a not-for-profit Florida Cbrporation
City
Units OJ llA & B
Street
FL
State
Suite
33140
Zip Code
(a) If a corporation, partnership, or trust, identify and provide the address for the chief officer, partner,
beneficiarY or interests,
see ExhiI::iit "A" attached.
3)
Subject Matter (Describe in Detail): .
Application :tor Conditional Use Approval to operate a religious institution in an
HM.::S Q1SLI~C't:; Rpp.Ll.caci.un :for ~ L.ltl(,;d~ vI Utiej l~uLldL.i.uu.~ willl o..x1~ wllpliculU;::
~~. iP~
4.
Board, Committee, Authority member or City staff)
~--
5. The subject matter in number three (3) above is to be considered at the meeting of (Identify each entity or
individual):
CJ The City Commission on .2001
CJ City Commission Subcommittee on ,2001
CJ City Staff on .2001
CJ City Board or Committee on 10/30 ,2001
CJ Personnel on ,2001
CJ Identify Others on ,2001
6, State the extent of any business, financial, familial, professional or other relationship which exists with any
individual identified in number (4) above: N/A
ON OCTOBER 1 Sf OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STA'fEMENT UNDER OATH, LISTING 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 2-482 of the Miami City Code as amended, and all reporting
requirements.
Sig~ture of Lobbyist:
iii' Personally known
CJ Produced ID
CJ .)1Id take an oath, or
~ Did not take an oath
Identify
State of Florida, County of Miami-Dade
Sworn ;0 and SUbSCrib~ b,efpre me
This 'f1t day of 't1DIJW , 2001.
d
If Notary, print,
Registration:
FOR CLERK'S USE ONLY
[ ~CCEPTED [] REJECTED DATE: i 0 / q /0 I
I
If rejected, state reason:
Registration fee paid: [.,Kfes [ ] No [] Not-for-Profit Organization
[ ] Cash [vrCheck MCR # :2-'f-o 2..:z..3
DATA ENTRY DATE:
,2001
ENTERED BY:
~ivision of Corporatiop"
Page 1 of3
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Exhibit nAil
Florida Non Profit
\
THE KABBALAH CENTRE OF FLORIDA, INC.
m'""".m"._".'"
PRINCIPAL ADDRESS
8411 PALMETTO PARK RD.
BOCA RATON FL 33433
Changed 04/20/1999
..... .......,.-....--,---_..... "'
MAILING ADDRESS
8411 PALMETTO PARK RD.
BOCA RATON FL 33433
Changed 04/20/1999
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Document Number FEI Number Date Filed
N95000002712 650638140 06/12/1995
State Status Effective Date
FL ACTIVE NONE
Last Event Event Effective
AMENDMENT Event Date Filed
AND NAME 11/09/1999 Date
NONE
CHANGE
........-.--.,
Registered Agent
.../cordetexe?a1 =DETFIL&n1 N95000002712&n2 NAMFWD&n3=11 0/5/0 1
Division of Corporations
Page 2 of3
I Name & Address I
THEKABBALAAHCENTER
8411 W,P ALMETTO PARK RD,
BOCA RATON FL 33433
I Name Changed: 03/02/2001 I
I Address Changed: 04/20/1999 I
..m."...__nn__""_._."_"_...... ...._.,....,_....".........._..._.. ........................,_...____,
Officer/Director Detail
I Name & Address II Title I
BERG, KAREN G
7411 WEST PALMETTO PKRD
BOCA RATON FL 33433
SARFATI, SHIMON []
8411 WEST PALMETTO PKRD
BOCA RATON FL 33433
SOLOMON, BETTY []
1062 S ROBERTSON BLVD
LOS ANGELES CA 90035
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Report Year Filed Date Intangible
Tax
I 1999 II 04/20/1999 II I
I 2000 II 07/12/2000 II I
I 1001 II 03/02/2001 II I
Annual Reports
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..Jcordetexe?a1 =DETFIL&n1 N95000002712&n2=NAMFWD&n3= 10/5/01