Wayne M. Pathman - Pathman Lewis LLP MIAMI BEACH
City of Miami Beach 16/1 /11 .
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: / Ju1fl . () - Ped-K
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Business Name: I t t a¢-w L P
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Address: �. > � �5 � �� C��'yt t
Office Telephone Number: -3�`� - 3 Z'-(2')
Cellular Telephone Number: 3 Q`; 33
Email Address: G3 f wi v
If more than one lobbyist,please list:
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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#: LiC7 %5
cc� 1.0/\Amount paid: , I/�DM� Date paid: l 15-
Processed by: Date:
F:\CLER\$ALL1aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx