Loading...
Russell W. Galbut Annual Lobbyist Registration Form MIAMI BE City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 www.miamibeachfl.gov City Clerk's Office Tel: 305-673-7411 Fax: 305-673-7254 Office Use Only ANNUAL LOBBYIST REGISTRATION FORM /6</-t- Name: Business Name: `'`� Address: -2_--- eZ) 61sc--74e- J G ce Office Telephone Number: 3(---)S �' '3°0 Cellular Telephone Number: 170S 17.S Gq-3-Z Email Address: ( /4LA6 C cs-Je Gt� ''t If C�✓r'L� more than one lobbyist,please list: 1) 2) C — �# V'7 3) 4) 5) ^ y 6) ��.. 7) Submit this form to the Office of the City Clerk, along with a check for $500 for each lobbyist. Please make the check(s) payable to the City of Miami Beach. For City Clerk's Office Use Only V MCR#: CiY(C WO Cie Amount paid: Date paid: t ( Ic Processed by: C ( �^-Q Y Date: t ( � F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx E R O F),FI LL CASHIER 0 DR HAENTION CN139 0 CONVHFL 330� (1057_ r i d a 170MIAMI BEAC , Beach-Flor000000000125301:41283492373 8 5 of Miami 121 .01 t ID: Fin- BR; T # 5 1 1 * rkMerchanID: RD City Ha0l l E?0/2021 51 Trana-City Clex:erinal DT CA 1 1 -1 , 01 : - MCR T109m0573940 CRE L 1057 7 15028n28,2U1RCi ERK AMEX 5AE 001 Ned 4a000 1C 0001454 1 $5101 440 0a. 0 565020 5R#: TAL; i00 ed 1C : TO $5 fSwip Il E k �r PAID CARD# 1 it CaINVOICE Cred dy!Batch#:l Code: $5UUOO O ce aHave a niovaAppy Method: . y sa ' ,._ . {?_y.aw,�„+ -,.- _ � apMode: _r Y., .- '^�e P /. Skn ._ ? ; ey f T.- __ m f ? ;'q SALE AMOUNT MER COPY �Y y .�s Y_ a a yko { F CUSTO .3>,l u f E ap . ' 3 t�"P` T-aF a n - y i er r# . x� :S T i 2 ,�.y 1 , r T i , !. '.$ a s t£ -„ : : ; � a:r f G- s 5Q t t rt rs f 3i ? , t � r •e r�R+d '-yC_ : a. Rec ' _ R & y '� f r, a k i ,«,} '- , '� , r ttt+ Ym wfwC_ _ ; R 7 -' � 3al V`t °�; . (".$*s . ` 'v i_ M J + + _ A X � I- t,, x ? 20 ra " 'S.L n ' � " ..�� a I. - to � , t$3= "s i R _t �, k = r {y ::+ . , s r RO.;S 1. b1T eL a S -?,4;.'-1=!..',1171-''''''t k , ,e*4 .,}y} }f,,i: . ;:.'C' ;Vila i ,%,;4 s '' � hBV _ � ,, J , -s { , S s a t r t 4' f C e ar ] , , � �F r.p k' ' w:c x ,,—fi � Y F Card � :- 4�, ` 1'5 Sitia ,n 8� ` cr edfti,i`i t� r. t1 7L/ . _`-. t ... - r•u .` fr iaS�t" { -y' �-# ,3 o a b z ,+: , .� .gYS r - b sh 1 i 3 t - q 13 Y s rm ` - 5 : C4 1 " i t t } r r $ rd• .1 A � k : 9 „3 Z;t e hecto „� `z . i t � 1s b r r #,I r- s-�* ,v� ! "`”` _ ' t re A r"f Finn c - °rt .�nae !Y r V , t j� S f a oS , Fi {k.. R4Ce �3 i - _ - �' a ' '-y ;F�j 5 ;� j i 2 � it 3 - n i - x . t f i k,tt H �or , - x d ��D} . -• � , '? a, F .. j r c P .ETE , } r �, s z ' t = t n z F z,'-', :: ' " V-k- .'r:E 7.� GE)M!;:'q L%',-a x ; .,.* �Y r - �' a y S4s1 f. G 3•• Y u LT B D i ! j� 4t" r r, : ' : ik fr: r a. �.O:N MUS } & " � r, r :`q �� 3 t Y: R MA,TIa e 'i � � - r p r t sq ..` ',• -'r _ H�QS i,NCOd r ?r C" . t- . `l k r a - 1 '� ' �'f r: r'�`l n�� " � t x j� ' W:�; F; �} + � 43 �t 1 < :O y� om i ice.� ber r g "W , _ r ' .r� -.,"° �•�: -r07w+"' ; r a ,q � y �1 i k a C K x"W y {a pa3 . u 1 ca T tfk "t� t _',IZm 3 :e� ,c r U a i= 3 a;a-.'41 ...