Billie Gimenez - Miami Beach Community Church, Inc. MIAMI BEACH
City of Miami Beach 2016 JUL 6 2 �iri 7: 43
1700 Convention Center Drive
Miami Beach, Florida 33139 CITY '!;! �'' i I
www.miamibeachfl.gov
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: Billie Gimenez
Business Name: Miami Beach Community Church, Inc .
Address: 1620 Drexel Avenue , Miami Beach, FL
Office Telephone Number: ( 305 ) 538-4511
Cellular Telephone Number:
Email Address: bw . gimenez@yahoo . 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.
Ak
For City Clerk's Office Use Only
MCR#: iA)
Amount paid: J V c A Date paid: Ai ° A
Processed by: J4 SG h l udo re Date: 7(1/ )
F:\CLER\SALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx