Kent Harrison Robbins - Palm V iew Residents Association T
1
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
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.
Robbins Dent Harrison
NAME OF LOBBYIST: (Last) (First) (M.1)
1224 Washington Avenue Miami Beach Florida 33139
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
(305) 532-0500 (305)531-0150 khr @khrlawoffices.com
TELEPHONE NUMBER: FAX NUMBER.- EMAIL:
Please notify this office if your contact information changes:address,phone, or e-mail address.
I. LOBBYIST RETAINED BY:
Palm View Residents Association, an unincorporated political association, and its individual members.
NAME OF PRINCIPAL/CLIENT:
See list of members with address and contact information attached hereto
BUSINESS NAM`AND ADDRESS (Number and Street) (City) (State) (Zip Code)
TELEPHONE NUMBER: FAX NUMBER:-(Optional) EMAIL:(Optional)
-;Il out this section if principal is a Corporation;Partnership or Trust[Section 2-48P(c)] --- -- ----
e NAME OF CHIEF OFFICER,PARTNER.,OR BENEFICIARY:
Joe-Tom Easley, individual Mlember and Legal Liaison �
IDENTIFY ALL PERSONS HOLDIN DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST:See�ist of members with address and contact information attached hereto
ii.SPECIFIC LOBBY ISSUE:
Legal Representation of Palm View Residents Association,an unincorporated political association, and its individual members,concerning matters
related to the development of the 2ropery located at 1729 Lenox Avenue,Miami Beach,Florida.
Issue to be lobbied(Describe in detail):
III.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2-482(a)(4)inciude the commissioner or personnel sought to be lobbied,and whether the lobbyist 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 general nature of the subject contractual relationship.
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
L title of person to be lobbied _
Zoning Board of Adjustment None
Planning Board None I X
. esign eview oars— - — ---
Land Use Board None X
I- --
�Planning Staff Nona
X
LUavor None X
Pursuant to City Code Section 2-482(8)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(p),Any Financial,Familial or Professional Relationship
Historic Preservation Board
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
v
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
$375.00 / per hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $375.00 / per hour
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues".
_Yes_)(No: 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 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_XYes 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 2-482(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.
YesXNo: 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 C MPENSATION RECEIVED E CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATE M ENT-SHALf BE FILE11,5VVN IF THE' EEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIO
�..
S' na re OT LODbISI
I do solemnly swear that If th foregoing facts re rue and c ect and h I ve read or am familiar with the provisions contained
in Section 2-482 of the ach City ode a porting quir n
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENT CATION: PRINCIPAL IDENTIFICATI N:
Produced ID Produced ID C)L _ qJ�-14D-310
,111119!1111/Pp, �
Form of Identification �o���N1E Form of``�@►1 H /1"
Ns
ersonally known(Lobbyist) AZ '�di1 Personally known if * s
VII. SIGNATURE AND STAMP OF NOT9I :; P.
M' �Ist�Ap E19140 �
State of Florida, County of Miami-Dade State of Florida, CountDade 9 oQ
S or subscri efo a me �'�99/- O�^�' , Sworn a subscr .•'•
I O
is n� '! day of 01L ����i��P��C;� This day o �,� • �F ��`��
s�fIFlI 111111111
SignalFre of Public Notary-State of Florida 4siatu o _u"151ic Notary-State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Dat Paid
Lobbyist Registration Form received and verified by:
F.\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014
F-\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
$375.00 /per hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $375.00 / per hour
The following Information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes_)(No: Are you lobbvinq 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 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_XYes 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 2-482(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.
_YesXNo: 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 REC D IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALLAE FILED VEN IFAHEAE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyist
I do solemnly swear that all of the foregoing f is are tru and corr ct nd th t I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Beach Ci a and al orting r ui
Signature of Lobbyist:
Signature of Principal/Client:
.. �,� PRINCIPAL IDENTIFICATION:
VI. LOBBYIST IDENTIFICATION: .....
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e 22 44 -
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_Produced ID e•���22 Produced ID J�� �t t I� 1/R��yv--o �
Form of Identificatior Form of Icnfr iora..
Zo 1409: Q � � . comwss
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Personally known(Lobbyist) %�99` ISt s:•' oQ�� cl Personally known(Pr ° - n
VII. SIGNATURE AND STAMP OF NOTARY: �li►�r llp10\ ;��°• �fr9 90
G� .4 Is(State\c�;%
State of Florida,County of Miami-Dade State of Florida, County of M
Sworn t and subscrib efore me Sworn subscri d fore m
�g r Jill\\
his ` day of 01� This� day of 01 f
1
*..i ture of Public Notary—State of Florida gn ure o ublic Notary—State of Florida
ota rization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual'Reglstration fee: [ ]Yes[ ].No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
$375.00 / per hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $375.00 / per hour
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes_XNo: 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 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues
X 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 2-482(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.
_Yes.XNo: 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 ZE FILED EVEN IF TMRE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD. jL1 )�
Sig ture'of
I do solemnly swear that all of the go: g facts are rue and r ct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Be Code a a repoXjj�ments.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION: S7 �i PRINCIPAL IDENTIFICATION:
0.®Produced ID `a• '�9 ••••• Produced ID
Form of Identification ® � o � Q `- ; ' a Form of Identification
®Personally known(Lobbyist) y• `' •° �,°• e`� ®Personally known(Principal)
VII. SIGNATURE AND STAMP OF NO Y: b 4RIDA
State of Florida, County f Miami-Dade •�'ot�YP�'a�� Stat of Florida, County of Miami-Dade
tY ,r, . �� ARACELIA PUPO �
Sworn to and subscribed efore me * Notary Public-State of Floo nd subscribed before me `�0.
is day of /, 011 ;�9 1 �a My Comm. Expires,tan 6,219
s 1 day of , 201_1
",OFF Commission#EE 862672
AA a ig a re o ublic otary— tate of Florida ignat re is o ary—State of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
F,.„i::G1.✓n;& }:.'e"'2 a,x>� - �rmf,f s': t�"qe!yas` a n; tc i '^e
Revised 01/22)2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
$375.00 / per hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $375.00 / per hour
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes_)(No: 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 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_XYes 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.
YesXNo: 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 RECEIVE THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENTS L BE FILE N IF THEKE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lobbyis
I do solemnly swear that all of the f regoing facts are true and_Qprrect and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miarn City Code d II repo ng irements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATIO Cc ;e�� • op• �
►�ussr �Q / PRINCIPAL IDENTIFICATION:
of ._
Produced ID Produced ID
Form of Identificazo6 #EEf9149 . � Form of Identification
0
i 9 .?�q `R� .Istsw Q'
Personally known (Lobbyist) ,i��G���C ••••'OFV O N` Personally known(Principal)
S T ATE
VII. SIGNATURE AND STAMP OF NOTARY:
Stat of
State of Florida, County of Miami-Dade ,.�,"Jak P&"I- ARACELIA PUPO Florida, County of Miami-Dade
or ea�subscri before me 'r#+ «,�`'= Notary Public-State of Flo Sw n aJ�d subscribed before me
is day of 01 ?•• *•_ q9i �1 day o ✓Q 201_q
-� V My Comm.Expires Jan 6,2017
A A nAD
Commission#EE 862672
Sign ure of Public o ary—State of Flori a ublic NA — ate of Florida
Notarization of Lobbyist's signature Notarization of Principal's gnature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
;Ct.b <ya LL\�s {3 t�la;€o?t3 'T,l"F°��f Ce S\i.r Ixi*ifim Annt.4A F�eoyts;ratio i porn doc Revised 01/22/2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
$375.00 / per hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $375 00 / per hour
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes_)(No: 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 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_XYes 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 2-482(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.
YesXNo: 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 FOMPENSATION RECELYED, IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENTS A L BE FILE EVEN IF R HAVE BEEN NO EXPENDITURES OR Y D.
COMPENSATION DURING THE REPORTING PERIO �L
—7 . 9—L===�
Sig ature of Lobbyi t
I do solemnly swear that all of je !!City going fa a e true an correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Miami Co all re i re irements.
Signature of Lobbyist: .- ,
Signature of Principal/Client: Io
\E R•
VI. LOBBYIST IDENTIFICATI e. °•••°°.• C ���� PRINCIPAL IDENTIFICATION:
on
~moo vc3�Q t2.20y'lir
ca •° L
Produced ID e ;.q = X Produced ID lk-
Form of Identification e o Form of Identification
s� #EE191g09 •
Personally known(Lobbyist) !' 0199�• 'den� °o��'\\``� Personally known(Principal)
VII. SIGNATURE AND STAMP OF NOTARY: ////UBLIC,S�P ���`!
State of Florida, County of Miami-Dade �'SPav P�e''� ARACELIA PUP C§tatip o lorida, County of Miami-Dade
o �,s
S orn t and subscri efore me �* * ? Notary Public-State ofSF F d subscribed before me
s day of ,1 01 N° *� My Comm.Expires Janth day o 201
11 e Commission#EE 86267
Art
�T P��
nat re o Public otary State of Florida Signature of Public No S to of Florida
Notarization of Lobbyist's signature Notarization of Principal's signature
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY
Annual Registration fee: [: ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
R\CLER.\$ALL\aFORM \LOBBYIST FORMS\Lobbyrist Annual Registration Form.doc Revised 01/22/2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required)
$375.00 /per hour
B) PRINCIPAL'S DISCLOSURE(OF LOBBYIST COMPENSATION):
(REQUIRED). $375.00 /per hour
The following information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes_)(No: 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 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues": ;
_XYes 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 2-482(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.
_Yes.XNo: 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 RECEI ED IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL I&E FILED EVEN IF E HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signa ure of Lobb ist
I do solemnly swear that all of tYach foregoing fa s are true correct and that I have read or am familiar with the provisions contained
in Section 2-482 of the Mia City and all r o requirements.
Signature of Lobbyist:
Signature of Principal/Client: ZZI .. _--�
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
_Produced ID ,.� 5 _.•off;•. G.� � ®Produced ID
Form of Identifcn:` PQA 22� •. n Form of Identification
/' Personally known(Lobbyist) :• EE191 9 .: _Personally known(Principal)
i
19 .,% �
VII. SIGNATURE AND STAMP OF NO' S':' ':••'oQ�Q\.`��
��l l l I STATE��� ��\\``
State of Florida, County of Miami-Dade State of Florida, County of Miami-Dade
Sworn o aj subscrib fore me Sworn and subscribed before me
T t `I'r1 day of 201 This I0 day of ,201 I�[
A
YP
ignatur of 010,61ic Notary— to of Florida Sigri'aftire of Public Notary—State of id ANGELACiIP>•TiU
Notarization of Lobbyist's signature Notarization of Principal's signatu * MY COMMISSION IFFMW
EXPIRES:August 24,2017
Servim
i �f70F A-W, Bonded Thru Budget Notary
TO BE COMPLETED BY CITY CLERK'S STAFF ONLY 9
Annual Registration fee: [ ]Yes[ ]No Amount Paid$ MCR# Date Paid
Lobbyist Registration Form received and verified by:
F:\CLER\$ALL\a FORMS\LOBBYIST FORMS\Lobbyist Annual Registration Form.doc Revised 01/22/2014
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
I
d
City of Miami Beach, 1700 Convention Center Drive,Miami Beach, Florida 33139,www.miamibeachfi.gov
CITY CLERK Office
Rafael E, Granado, City Clerk CityClerk @miamibeachfl.gov
Tel: 305.673.741 1 , Fax: 305.673.7254
LOBBYIST NAME: Kent Harrison Robbins
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, 20129 shall be
automa cally suspended from lobbying until all fines are paid, unless the fine has been
ap eal d to the JMjmi-Dadj m y Commission on EtVcs and Public Trust
Sig' ature: V 6ate:L
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form.doc
PALM VIEW RESIDENTS ASSOCIATION
An unincorporated political association
MEMBERS
by Joe-Tom Easley,
Individual Member and Legal Liaison for Palm View Residents Association
Joe Tom Easley
Peter Freiberg
1743 Michigan Avenue
Miami Beach, FL 33139
Jay Levy
Claudia Levy
1753 Lenox Avenue
Miami Beach, FL 33139
Sheryl Gold
1711 Michigan Avenue
Miami Beach, FL 33139
Richard Silverman, MD
Wayne L. Grabein
1800 Jefferson Avenue
Miami Beach, FL 33139
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