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W. Tucker Gibbs - George Perez City Of Miami Beach Lobbyist Fee Expenditure and Compensation Form City Code Section 2-485 Expenditure report for period of:1/1/2015 through 12/31/2015 . • A statement shall be filed even if there have been no expenditures or compensation during the reporting period. • This statement is to be signed,notarized and returned to the City of Miami Beach,City Clerk's Office, 1700 Convention Center Drive, Miami Beach,FL 33139 by February 28th.A fine of$50.00 per day,per issue,shall be assessed for statements filed after the due date.If you require any assistance, please contact this office at 305.673.7411 or at cityclerk @miamibeach.gov. Lobbyist W.Tucker Gibbs Principal`.; George Perez Issue 6525 Collins Avenue PLEASE COMPLETE THE SECTION BELOW Detail Compensation Received: 40. UO CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: Research: Communications: />> \/ Media Advertising: Publications: Travel: ‘ \ Lodging: Special Events: VCHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: S—t— t r OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath and affirm that the information disclosed herein and any attachment hereto are true and correct. )/1,/f, �x��� Lobbyist Signature SIGNATURE AND STAMP OF NOTARY: Produced ID t-4/ .AILA Form of Identification Signature of Public Notary—State of Florida Sworn to and subscribed before me Personally known . ,∎Zj:KYtPliab, LILLIAN BEAUCHAMP ?a�•"'1• _ Notary Public-State of Florida •='• c MY Comm.Expires May 5,2018 •yr,;. '%-'4.•o P Commission # FF 115190 ,