Graham Penn - Miami Beach Jewish Community Center City Of Miami Beach
Lobbyist Fee Expenditure and Compensation Form
City Code Section 2-485
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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`reportingperiod. I `t•:
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 Graham Penn
Principal Jay Roth-Miami Beach Jewish Community Center
Issue Development Approvals for 4221 Pine Tree Dr.MB Jewish Community Center,
PLEASE COMPLETE THE SECTION BELOW
Detail Compensation Received: $475 per hour
CATEGORIES OF EXPENDITURES
$0
Food and Beverage:
Entertainment: $0
Research: $0
Communications: $
Media Advertising: $0
Publications: $0
Travel: $0
in $0
Lodging:
g�
Special Events: $0
CHECK BOX IF YOU NO LONGER REPRESENT THE PRINCIPAL FOR THE ABOVE ISSUE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 di-clo -d herein wad -ny attachment
hereto are true and correct.
_ s
Lori: Signature
SIGNATURE AND STAMP OF NOTARY: /
Produced ID
Form of Identification Signature ublic Notary—State of Florida
Sworn o and subscribed before me
V Personally known Thisd tday of.1"yo yo 11:
P(, Notary Public State of Florida (L
494"11 Diana Ramos �7
e My Commission FF 207719
Expires 0411012019 -