Neisen O. Kasdin Harry "Skip" Nashfi
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
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• NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
• IDENTIFY ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 556 OR MORE OWNERSHIP INTEREST IN
SUCH CORPORATION, PARTNERSHIP OR TRUST:
LOBBY ISSUE:
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I:etle ro o. ~~ (Dea«we in detaill~ -
uLCITY AGENCIES/fNDIVIDUALS TO BE LOBBIED: Purewrttto Coy Code Ssetlon 2.482(8) include
• slabment of the sacterrt of any business, finautt:lsi, farniNab professional or other relationship, giving rise t0 an
apperrance of an Impropriety wMh any City personnel sought b be bttbled - ftrrthsr, pursuant to Cky Code Section 2-
482(a)(4) include a stabmeM of any ConU~acttul rNatlortship {paid or unpaid( from i2 months preceding said City
personnel' commencement of service with the City to the present dab, stsdng rile general nature of the subject
coMtactwi relatloo.
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LOBBYIST REGISTRATION FORM
Lobbybt mwna aiF persons anployed w retained, wfteax paid w rot, ty • prN>cipeil who seeks to enoourape Yte passage, dNaet a madlfrcxtion of
any ordirtanca, rasohdlon, action w dedsbn d any oDrtlrniaiiorler; any adiorr, decision, rraatxrtandatan athe Cify Manager w eny city ?wed w
corrrrvttas; or any aebon, decision of rocomrssndatiwl d arty city parsomei during the t4na psrbd d the anthe dec~lon-making process on such
aetrDn, decbion w reoanmendafbn that toreseeably will be heard w reviewed by the pry tmrrtmission, w ^ city board or committee. The term
epeaYralb includes the prineipat ea weN as roY smpbyee wrII+gad in iobbying acllvkfas. The arm "Lo
__ _ „___ _ ___ myaa" has tpecitic exciusions. Plesae
IV. DISCLOSUR@ DF TERiI18 AND AAAOUNTS OF LOBBYIST COMPENSATION (DISCLOSE 11YHETHERlfOf1RLY, FLAT
RATE OR 07NE1~: .
A) LOBBYIST DISCLOSURE: (Raquind)
PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION);
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Ths following information must be answered:
Pursuant to Miami Beach City Code Section 2-488 Entitied'Prohib3ted Campaign Contributions t3y Lobbyists
On Procurement Issues':
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3) Pursuant to Mfaml Beach City Code 2-484 (h) Any person (except those exempt from the definition of
"bbbyisC as set forth In Section 281 above) who only appears as a represeMathre of a not for-profit
corporation or entity witlwut spatial compensation or reimbursement for the appearenoe, whether direct, or
indirect, to express support of or oppoalUon to any item, shall register with the derlc as required by this
,~~ection but, shall not be required to pay any registration fees,
^ Yaa ~I No• Are you r+eoreseM[na a notdor.~roflt eorooratton or anttty without soeclal cQmoensation or
~tmbureement. .
v. slcw-TURE UNDER oarH:
Signature of Lobbyist:
Signature of PrincipaUClient:
VI. LOBBYIST IDENTIFIC N:
^ Produced ID
Form ofldentification
~rsonally known (Lobbyist)
VII. SIGNATURE AND STAMP OF NOTARY:
State of lorida, County taint-Dade
Swom sub
This day of 2010
Signature of Public Notary -State of Fbrida
Notarization of LobbvisYs sSgnaturo
Annual Ragistratlon toe: j~] Ysa [ ] No Ama
Lobbyist Raptsiration Form ncaivad and verHisd
PRINCIPAL IDENTIFICATION:
I.i, Produced ID
Fonn of Identification
PersonaNy known (principal}
State Of.Ftorid8, COUnty of ~~~ ~ m
Sworn and sub before me
This ~Q_day of , 2010
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Signatu Public Notary -State of Fbrida
Note on of PHncinel'a :ignature
Paid
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2) Pursuant to Miami Beach City Code 2-490 Entitled "Prohibited Campaign Contributions By Lobbyists Qn
Real Estate Development Issues`:
I do solemnly swear that atl of the foregoing fads are true and correct and that 1 have read Or am famYiar with the
provisions contained in Section 2f the Miami Beach City Code and alt reporting roquirements.
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Ci1p ai Miami leoci~, 1700 Comenlion Center Dri~re, Miami Beach, Florida 33139, www..niamibeochH.gov
CITY CLERK Office CityClerk@miamibadthfl.gov
Tel: 305.673.7411 ,Fax: 303.673.7254
Acknowledgement of fines/suspension from lobbying for f+aiiure b
.amply with City of Miami Beach bbbying laws
LOBBYIST 1VAME: ~~) Sew fl ~ ~~ V DID
1 undersrond that no later than October 1 st o ~ each Xear• lobbyists subject to lobbyist
registration requirements shall submit to the city clerk a signed statement under oath
listing all lobbying expenditures, as well as compensation received, for the preceding
calendar year with regard to the specific issue on which the lobbyist has been engaged
b lobby. A statement shall be filed even if there have been no expenditures or
compensation during the reporting period. The statement shall list, in detail, each
expenditure by category, including food and beverage, entertainment, research,
communication, media advertising, publications, travel, lodging and special events.
Failure b timely fife the expenditure and fee disclosure report will result
in a fine of X50.00 per day. Any lobbyist who foils b fik the required
expenditure report by December 7, shall automatically be suspended
from lobbying until all fines aro paid, unless the fine has been appealed
b the Miami-Dods County Commission on Ethics and Public Trust. In the
event a lobbyist fails to either file the report and/or pay the assessed fines, the Clerk shall
notify the Miami Dade County Commission on Ethics and Public Trust.
fn addition, once an issue I have registered to lobby on has been resolved, I am required
to immediately notify the City Clerk's C-ffice of lobbyist withdrawal in writing.
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Signature: Dote: