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Jose Villalobos - Akerman LLP i ry 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: JOSE VILLALOBOS Business Name: AKERMAN LLP Address: ONE SE THIRD AVENUE, 25TH FLOOR, MIAMI, FLORIDA 33131 Office Telephone Number: 305-982-5625 Cellular Telephone Number: 305-215-1680 Email Address: jose.villalobos @akerman.com If more than one lobbyist, please list: 1) 2) 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#: "II 1� Amount paid: -c V Date paid: 9 30 ∎ Processed by: Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx I , ...;._-.:"." ,i,..,, .. Ad City of Miami Beach-Florida Finance Department 1 City Hall 1527320-1 09/30/2015 BR1 T131 Wed Sep30,2015 11 :49AM Trans#11-11 11 $500.00 MCRCLERK - MCR-City Clerk * MCR#: 407198 1 ITEM(S): TOTAL: $500.00 Check (30017316) PAID $500.00 Have a nice day! Miscew'ts",4ous Cash Receipt 1' is i)1.. - :4r3 4 b 00 . s: .� a CITY 01- 1�4.4,i . BEACH IA; � s't = .l� . ;'� t'� P gel .� �P Y ! >.L S, ` -' a�,� r}. xr •,"1T-fir e t,,, -a:- zo-f' ,; c 3: i''.410-01-',':,:::'-- ,,:< I 1- '-'---.-' -.-):- r i " ' ' . ., ... .p., � c - ❑ Cash D Credit Card L4 Check# Li. ( 8 _ i $ - - . = --_(/so- 20 / - ved of -' o - h.1 Recei _ - Address 1 Ai. - a. I._ '- t' ,. } �-+�: ft` t_ . For / / _ � J i1 ~ if -- - - - - - f: - Office®f Finance Director (THIS INFORMATION MUST_BE COMPLETED) =f i g N Account Number. fi - - /` f. j —7(//j' ' ,, �L�: „_ i .- Dept: C-- -,.... EXT Preparers (-4--f � .: ::a