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Michael I. Abrams -Annual Lobbyist Registration Form MAMt B 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 @ballardf1.com --a + If more than one lobbyist,please list: 1) Michael I. Abrams (email: mike@ballardfl.com) 2) Sylvester Lukis (email: syl @ballardfl.com) co - , 3) 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#: bO Lc/ L� Amount paid: (( 500 .0 0 Date paid: 0.2)/1 V)5 Processed by: TC A-fEck Ca PI r-■ Date: 01111,//5- l ( F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx 7R-f■f) Qt 9)1151 I)