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Annie Carruthers - Edmund Irvine City Of Miami Beach Lobbyist Fee Expenditure and Compensation Form City Code Section 2-485 A Expenditure report for period of 1/1/2015 through 12/31/2015 a ;! ? 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 cityclerkPmiamibeach.gov. Lobbyist Annie Carruthers Principal Edmund Irvine Issue Present to DRB for residence at 1433 W.22 St PLEASE COMPLETE THE SECTION BELOW f �� Detail Compensation Received: IAifl GOJiAi 5Q i'O/1 CATEGORIES OF EXPENDITURES Food and Beverage: Entertainment: Research: Communications: Media Advertising: Publications: Travel: 0 Lodging: 0 Special Events: CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE DATE REPRESENTATION ENDED: OATH State of Florida County of Miami-Dade I,the undersigned lobbyist,do hereby depose under oath and affirm that the information disclosed her/ . d any attachment hereto are true and correct. AIL Lobbyist Signature SIGNATURE AND STAMP OF NOTARY: XProduced ID Loc. ®tom 9V3 / C'Q1 �--- Form of Identification Signature of Public Notary—State of Florida p06 Diane J.Congdon Sworn to and subsc ibed before me Personally known °'xt,,e1„ State of Florida This 1 day of F� 20 fop, .. My Commission#EE 216647 °Kf‘,04, Expires:July 16,2016