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Harold "Hunter" Thompson - Miami Beach Community Church, Inc. MIAMI BEACH City of Miami Beach 2016 JLII_. 2 6+ 7 47 1700 Convention Center Drive C i r•( ``; i j- i C F 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: Reverend Harold "Hunter" Thompson 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: revhthompson@gmail . 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#: ( (A1/ � /� //� Amount paid: V c w L Date paid: " / r`► Processed by: 10t5u,A )4I Weft, Date: 7,'/ r r F:\CLER\SALL\aFORMS\LOBBYIST FORMSWNNUAL LOBBYIST REGISTRATION FORM reg.docx