Jeffrey Taylor - H&M Hennes & Mauritz LP 126 SA-re4Jr-
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MIAMI BEACH } "- 1 ;
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City of Miami Beach Office of the City Clerk `
1700 Convention Center Drive, Miami Beach,-.FL,33139:i v r F
LOBBYIST REGISTRATION FORM
Lobbyist means all persons employed or retained,whether paid or not,by a principal who seeks to encourage the passage,defeat or
modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City
Manager or any city board or committee;or any action,decision or recommendation of any city personnel during the time period of the
entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the city
commission, or a city board or committee. The term specifically Includes the principal as well as any employee engaged In lobbying
activities. The term"Lobbyists"has specific exclusions. Please refer to Ordinance 2004-3435.
Taylor Jeffrey
NAME OF LOBBYIST: (Last) (First) (M.I)
Taylor Associates-Archtects,AIA 572 North Broadway White Plains New York 10603
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
914-289-0011 914-289-0022 jt@taylorarchitects.com
TELEPHONE NUMBER: FAX NUMBER: • EMAIL:
Please notify this office if your contact information changes:address,phone,ore-mall address.
I. LOBBYIST RETAINED BY:
H&M Hennes&Mauritz LP do Helder Ferreira
NAME OF PRINCIPAUCLIENT:
H&M Hennes&Mauritz LP 110 Fifth Avenue,11 Fir. New York NY 10011
BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code)
201-736-5203 201-955-4923 helder.ferreira@hm.com
TELEPHONE NUMBER: FAX NUMBER:(Optional) EMAIL:(Optional)
Fill out this section if principal Is a Corporation,Partnership or Trust[Section 2-482(c)]
• NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY:
Alexander Kreffe
• IDENTIFY ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,
PARTNERSHIP OR TRUST: Publicly traded company
II.SPECIFIC LOBBY ISSUE:
Approval-of-sign varianaces for H&M store located at 126 8th Street)
Issue to be lobbied(Describe in detail):
111.CITY AGENCIES/INDIVIDUALS TO BE LOBBIED:
Pursuant to City Code Section 2.482(a)(4)Include the commissioner or personnel sought to be lobbied,and whether the lobbyist has entered
into any contractual relationship (paid or unpaid) with said city commissioner or personnel from 12 months preceding such person's
commencement of service with the city to the present date,stating the general nature of the subject contractual relationship.
Sec 2-482(a)(4)Full Name of Individual and Contractual Relationship(Explain) YES NO
title of person to be lobbied
City of Miami Beach Committees and Boards None •
City of Miami Beach Attorneys Office and Administration None ✓
City of Miami Beach Mayor/Commissioners None ✓
Pursuant to City Code Section 2-482(g)Every registrant shall be required to state the extent of any business,financial,familial or professional
relationship,or other relationship giving rise to an appearance of an impropriety,with any current city commissioner or city personnel who Is
sought to be lobbied as identified on the lobbyist registration form filed.
Sec 2-482(g)Any Financial,Familial or Professional Relationship
None
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION(DISCLOSE WHETHER HOURLY,FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:(Required) ri o itI c„�QD/DPvy
COMP
B) PRINCIPAL'S DISCLOSURE(OF LOBBYI EN�A_TIO�N): �J�J
(REQUIRED). \Z/'et� \\zoo l
The following Information must be answered:
1) Pursuant to Miami Beach City Code Section 2-488 Entitled"Prohibited Campaign Contributions By Lobbyists On Procurement
Issues":
_Yes✓No: Are you lobbying on a present or pending bid for goods,equipment or services,or on a present or pending
award for goods,equipment or service?
2) Pursuant to Miami Beach City Code Section 2-490 Entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate
Development Issues":
_Yes✓No: Are you lobbying on a pending application for a Development Agreement with the City or application for
change of zoning map designation or change to the City's Future Land Use Map?
3) Pursuant to Miami Beach City Code Section 2-482(h)Any person(except those exempt from the definition of"lobbyist°as set
forth in Section 2-481 above)who only appears as a representative of a not-for-profit corporation or entity without special
compensation or reimbursement for the appearance, whether direct, or indirect, to express support of or opposition to any
item,shall register with the clerk as required by this section but,shall not be required to pay any registration fees.
Yes,'No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement.
V. SIGNATURE UNDER OATH:
ON FEBRUARY 28 OF EACH YEAR EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER
OATH, LISTING LOBBYING EXPENDITURES,AS WELL AS COMPENSATION RECEIVED.IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR. A STATEMENT SHALL BE FILED EVEN IF THERE HAVE BEEN NO EXPENDITURES OR
COMPENSATION DURING THE REPORTING PERIOD.
Signature of Lodayis '
t
I do solemnly swear that all of the foregoing facts are true and correct and that I have read or am familiar with the provisions contained
In Section 2-482 of the Miami Beach City Code and all reporting requirements.
Signature of Lobbyist: I)
Signature of Principal/Client: (
VI. LOBBYIST IDENTIFICATION: PRINCIPAL IDENTIFICATION:
Produced ID _Produced ID
Form of Identification Form of Identification
V Personally known(Lobbyist) ✓ Person.i kn• •rincipal�EVIN J.FLANERTY •
VII. SIGNATURE AND STAMP OF N a� ' 3 NOTARY PUBLIC OF NEW JERSEY--MEW INE J.O'BRIEPI � IA-N 2433013
W�f1Q tic,State of New York � �
.State of e,--ounty of Fade o.01065069386 State of . n Y�=.f in Ion.Expires 412312018
Sk'rrito a .-subsc bed before me ^ratified in Westchester C unty
Sworn and s,i .• ., __••
Ty§ _ da''' �,..... scion Expires - - 8 This 3 day AMA. 201
% Lire of-u•tic Notary- •tatit-of.Ekstela Eutryca . Sig ature ublic otary-Ste : of Ftl3 rida/JO
•tarizat •• • obb fist's s .nature Note on of Principal's signature
TO BE COMPLETED BY CITY CLERK'S TAFF ONLY
Annual Registration fee: raw;[ ]No Amount Paid S dMCR# tf/O 99r Date Paid giVfro
Lobbyist Registration Form received and verified by: 4,14,e.l /
F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Annual egistration Form.doc Revised 04/27/2012
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MIAMI BEACH r
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City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miam beachiLgov - t
CITY CLERK Office ( (,Lc 5 ( r F I •
Rafael E.Granada,City Clerk CityClerk @miamibeachfl.gov
Tel:305.673.7411 ,Fax:305.673.7254
LOBBYIST NAME: Jeffrey Taylor, AIA
I understand that no later than February 28 of each year, I must file the following form,
pursuant to Section 2-485 of the Miami Beach City Code, with the City Clerk's Office for
all active lobbying issues.
1) LOBBYIST EXPENDITURE AND COMPENSATION FORM
Failure to file these forms on a timely basis will result in my name being transmitted to
the Miami-Dade County Commission on Ethics and for code violation evaluation.
In addition, once an issue I have registered to lobby on has been resolved, or I am no
longer lobbying on that issue or for that principal, I am required to immediately notify
the City Clerk's Office of lobbyist withdrawal in writing.
Pursuant to Section 2-485(d),the City Clerk shall notify any lobbyist(or principal)who
fails to timely file a Statement and in addition to any other penalties which may be
imposed as provided In Section 2-485.1, a fine of$50.00 a day shall be assessed for all
Statement(s) flied after the due date. The City Clerk shall notify the Miami-Dade
County Commission on Ethics and Public Trust of the failure of a lobbyist(or principal)
to file the Statement or pay the assessed fines after notification.
Any lobbyist, who fails to file the required Statement by April 30th, 2012, shall be
automatically suspended from lobbying until all fines are paid, unless the fine has been
appealed to the Miami-Dade County Commission on Ethics and Public Trust.
421((e
Signature: Date:
MIADOCS 1339658
MIAMI BEACH ,._ ,_ _
C,,. . ( r . I i .
City of Miami Beach
1700 Convention Center Drive 2016 AUG --ls 1:Ti 2: 12
Miami Beach, Florida 33139
www.miamibeachfl.gov CH Y CL:. <::,'S OFF i a
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name: Jeffrey Taylor, AIA
Business Name: Taylor Associates - Architects , PC
Address: 572 North Broadway, White Plains, NY 10603
Office Telephone Number: 914-289-0011
Cellular Telephone Number: 914-649- 9015
Email Address: jt@taylorarchitects . 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#: q o ? Sj-
Amount paid: J O. v d Date paid: -At 2.70i
Processed by: Date: g I 41-7,0/‘
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F:CLER%SALL\aFORMSILOBBYIST FORMSVNNUAL LOBBYIST REGISTRATION FORM reg.doa
Miscellaneous Cash Receipt
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(THIS INFORMATION MUST BE COMPLETED) Office of Finance Director .,
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Account Number Off" 006 45—3679't(((""' f? —30 2-3j�- '-i�C) ,_,U, ®U
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