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Genaro "Chip" Iglesias - Annual Lobbyist Registration Form I\ ii\ AAA1 E:: 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 Name: GENARO "CHIP" IGLESIAS Business Name: BALLARD PARTNERS Address: 403 EAST PARK AVENUE, TALLAHASSEE, FL 32301 Office Telephone Number: 850-577-0444 Cellular Telephone Number: Email Address: chip @ballardfl,corn - r,) If more than one lobbyist, please list: C 1) Michael I. Abrams (email : mike @ballardfl.com) - 5_ 2) Sylvester Lukis (email: syl @ballardfl.cor) r C 3) := cc, 4) 5) 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 MCR #: ioL7 Amount paid: L( 5o o ,0 0 Date paid: 0-2)/ �1)5 Processed by: TCA-fiCk, i'►r' Date: o�1I1 l ( F:\CLER\SALL1aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx 91- r-.213 r