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MIAMI BEACH
City of Miami Beach Office of the City Clerk
2013 NOV { 2 P11 12: 2 8
1700 Convention Center Drive, Miami Beach, FL 331391 1 f
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
modification 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 foreseeably 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 in lobbying
activities. The term "Lobbyists" has specific exclusions. Please refer to Ordinance 2004-3435.
So-tr. _eAr � e.r n a A/egg r C&
NAME OF LOBBYIST: (Last) (First) (M.I)
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
Please notify this office if your contact information changes:address,phone,or e-mail address.
I. LOBBYIST RETAINED BY:
NAME OF PRINCIPAUCLIENT:
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BUSINESS NAME AND ADDRES Number and Street) (City) (Sta ) (Zip Cod
013.3- G H oc -�--
TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional) tT
Fill out this section If principal is a Corporation,Partnership or Trust[Section 2-482(c)]
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY:
•
PARTNERSHIP OR TRUST:OLDING, '0 o nOR IN C"_.) Yn4 5%OR O E OWNERSHIP INTEREST IN SUCH CORPORATION,
ii.SPECIFIC LOBBY ISSUE: / C Q,�r' C�c.t1/�,�
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Issue to be lobbied(Describe in detail): fort, //_ fh p?,a�j ye- t aK 4' A4,47 �
III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: C,0^4"nC2 �� Cc4l,
Pursuant to City Code Section 2-482(a)(4)Include the commissioner or personnel sought to be lobbied,and whether the fobbyist has entered
into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's
commencement of service with the city to the present date,stating the eneral nature of the subject contractual relationship.
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of-�ersnpon to be O'd eS4-lobbied - n _ r
u C � v
Pursuant to C ty Code Sec l 87 g)Every registrant shall be required to state the extent of any business,financial,familial or professional
relationship,or other relationship giving rise to an appearance of an Impropriety,with any current city commissioner or city personnel who is
sought to be lobbied as Identified on the lobbyist registration form filed.
Sec 2-482 Any Financial Familial or Professional Relationship
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
O
(REQUIRED).
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues:
_Yes
V. Are you lobbying on a present or pending bid for goods,equipment or services,or on a present or pending
award for goods,equipment or service?
2) Pursuant to Miami Beach City Code Section 2490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes-No: Are you lobbying on a pending application for a Development Agreement with the City or application for
change of zoning map designation or change to the City's Future Land Use Map?
3) Pursuant to Miami Beach City Code Section 2482(h)Any person (except those exempt from the definition of"lobbyist"as set
forth in Section 2-481 above) who only appears as a representative of a not-for-profit corporation or entity without special
compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any
item,shall register with the clerk as required by this section but,shall not be required to pay any registration fees.
YesJflo: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES,AS WELL AS COMPENSATION RECEIVED, IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signa ure of Lobbyist
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 Beach City Code and all reporting requirements.
Signature of Lobbyist: az
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
4L?-57(0L1-0 V Produced ID � `r' ✓Produced ID S q'a r'(01)
. / Form of Identification Form of Identification
V
Personally known(Lobbyist) _Personally known(Principal)
VII. SIGNATURE AND STAMP OF N .r*"�►'`Y p'''••, MICHELLE HALLO
: ;•, fWCf+I�t. flALLo °mot Notary°ubllc-State of Florida
State of Florida,County of Miami-Dade ' Notary►Pink.•Oft of of Florida,C i nm.Expires Jun 20,2017
Sworn to d subscribed before me ; v t1Ay CW=.,bp M Jun 20.2 n qd subscri 'e Commission•Ff 028922
at
' � i 2012 -
, day day of 2012 �
Signature of Public Notary—State of Florida Signature of Public Notary—State of Florida
Notarization of Lobbyist's signature Notarization of Prin®signature
TO BE COMPLETED BY CITY CLERK'S STAFf ONLY
Annual Registration fee: [ ]YA61 ]No Amount Paid$ C 4# et►' O t Date Paid
Lobbyist Registration Form received and verified by:
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F:\CAE{ listration Form.doc Revised 04/27/2012
M A Nl A(*-.�, H
City of Miami Beath, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov
CITY CLERK Office
Rafael E.Granado,City Clerk CityClerkCmiamibeachfl.gov
Tel:305.673.7411 , Fax:305.673.7254
LOBBYIST NAME: ,,.&cr ?,a 4.42 ea v d-ze- J�" 0�-
I understand that no later than February 28 of each year, I must file the following form,
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 AND COMPENSATION 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, or I am no
longer lobbying on that issue or for that principal, I am required to immediately notify
the City Clerk's Office of lobbyist withdrawal in writing.
Pursuant to Section 2-485 (d),the City Clerk shall notify any lobbyist(or principal)who
fails to timely file a Statement and in addition to any other penalties which may be
imposed as provided in Section 2-485.1, a fine of$50.00 a day shall be assessed for all
Statement(s) filed after the due date. The City Clerk shall notify the Miami-Dade
County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal)
to file the Statement or pay the assessed fines after notification.
Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust.
�cr-la,
Signature: Date:
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OIRSINTERNAL DEPARTMENT OF THE TREASURY
REVENUE SERVICE
CINCINNATI OH 45999-0023
Date of this notice: 10-11-2013
Employer Identification Number:
46-3859287
Form: SS-4
Number of this notice: CP 575 A
IFCM CROP
INDIE FILM CLUB MIAMI
s DILIANA ALEXANDER For assistance you may call us at:
3 ISLAND AVE APT 3J 1-800-829-4933
MIAMI BEACH, FL 33139
IF YOU WRITE, ATTACH THE
STUB AT THE END OF THIS NOTICE.
WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER
Thank you for applying for an Employer Identification Number (EIN) . We assigned you
EIN 46-3859287. This EIN will identify you, your business accounts, tax returns, and
documents, even if you have no employees. Please keep this notice in your permanent
records.
When filing tax documents, payments, and related correspondence, it is very important
that you use your EIN and complete name and address exactly as shown above. Any variation
may cause a delay in processing, result in incorrect information in your account, or even
cause you to be assigned more than one EIN. If the information is not correct as shown
above, please make the correction using the attached tear off stub and return it to us.
Based on the information received from you or your representative, you must file
the following form(s) by the date(s) shown.
Form 1120 10/11/2013
After our review of your information, we have determined that you have not filed
tax returns for the above-mentioned tax period(s) dating as far back as 2013. Please
file your return(s) by 10/26/2013. , If there is a balance due on the return(s) ,
penalties and interest will continue to accumulate from the due date of the return(s)
until it is filed and paid. If you were not in business or did not hire any employees
for the tax period(s) in question, please file the return(s) showing you have no
liabilities.
If you have questions about the form(s) or the due date(s) shown, you can call us at
the phone number or write to us at the address shown at the top of this notice. If you
need help in determining your annual accounting period (tax year) , see Publication 538,
Accounting Periods and Methods.
We assigned you a tax classification based on information obtained from you or your
representative. It is not a legal determination of your tax classification, and is not
binding on the IRS. If you want a legal determination of your tax classification, you may
request a private letter ruling from the IRS under the guidelines in Revenue Procedure
2004-1, 2004-1 I.R.B. 1 (or superseding Revenue Procedure for the year at issue) . Note:
Certain tax classification elections can be requested by filing Form 8832, Entity
Classification Election. See Form 8832 and its instructions for additional information.
IMPORTANT INFORMATION FOR S CORPORATION ELECTION:
If you intend to elect to file your return as a small business corporation, an
election to file a Form 1120-S must be made within certain timeframes and the
corporation must meet certain tests. All of this information is included in the
instructions for Form 2553, Election by a Small Business Corporation.
Electronic Articles of Incorporation N12000006511
FILED
For July 03 2012
Sec. Of State
bmcknight
IFCM CORP.
The undersigned incorporator, for the purpose of forming a Florida not-for-
profit corporation, hereby adopts the following Articles of Incorporation:
Article I
The name of the corporation is:
IFCM CORP.
Article II
The principal place of business address:
3 ISLAND AVE
3J
MIAMI BEACH, FL. 33139
The mailing address of the corporation is:
3 ISLAND AVE
3J
MIAMI BEACH, FL. 33139
Article III
The specific purpose for which this corporation is organized is:
WE SUPPORT FILM, TV AND VIDEO PROFESSIONALS IN PRODUCING,
PROMOTING AND EXHIBITING THEIR WORK. WE HOLD SCREENINGS,
WORKSHOPS,FESTIVALS,COMPETITIONS AND CLASSES TO FULFILL
THIS MANDATE.
Article IV
The manner in which directors are elected or appointed is:
AS PROVIDED FOR IN THE BYLAWS.
Article V
The name and Florida street address of the registered agent is:
DILIANA ALEXANDER SLAVCHEV
3 ISLAND AVE
3J
MIAMI BEACH, FL. 33139
I certify that I am familiar with and accept the responsibilities of
registered agent.
Registered Agent Signature: DILIANA ALEXANDER SLAVCHEV
N12000006511
FILED
Article VI July 03 2012
Sec. Of State
The name and address of the incorporator is: bmcknight
DILIANA ALEXANDER SLAVCHEV
3 ISLAND AVE
3J
MIAMI BEACH, FL, 33139
Electronic Signature of Incorporator: DILIANA ALEXANDER SLAVCHEV
I am the incorporator submitting these Articles of Incorporation and affirm that the facts stated herein are
true. I am aware that false information submitted in a document to the Department of State constitutes a
third degree felony as provided for in s.817.155, F.S. I understand the requirement to file an annual report
between January 1 st and May 1 st in the calendar year following formation of this corporation and every
year thereafter to maintain "active" status.
Article VII
The initial officers and/or directors of the corporation is/are:
Title: P
DILIANA ALEXANDER SLAVCHEV
3 ISLAND AVE, 3J
MIAMI BEACH, FL. 33139
Title: VP
JOSE JACHO
14809 SW 84TH TERRACE
MIAMI, FL. 33193
Title: DIR
WILLIAM BETTS
3E-3 ISLAND AVE
MIAMI BEACH, FL. 33139
Title: DIR
JERRY SULLIVAN
806- 10175 COLLINS
MIAMI BEACH, FL. 33154
Title: DIR
DAVID BURLEY
2915 SW 30TH COURT
MIAMI, FL. 33133
Article VIII
The effective date for this corporation shall be:
06/29/2012