Ian E. DeMello - Annual Lobbyist Registration Form rr
MAW\I BEACH
City of Miami Beach
1700 Convention Center Drive
Miami Beach Florida da 33139 !. `FI o ri
www.miamibeachfl.gov
City Clerk's Office ' '
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: Ian E. De Mello, Esq.
Business Name: Shubin & Bass, P.A.
Address: 46 SW 1st Street, Third Floor, Miami, Florida 33130
Office Telephone Number: (305) 381-6060
Cellular Telephone Number: (202) 491-8195
Email Address: idemello @shubinbass.com
If more than one lobbyist,please list:
1) Ian E. De Mello, Esq.
2)
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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 #:_ LibLt I� t
Amount paid: % U Date paid: 6(7//7.5 -
Processed by: ft)arrliArv " Date:
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx