Thorsten Kiefer - Shore Club Property Owner, LLC . 1 BEACH . „
City of Miami Beach 2016 SL - 30 P=' 1: 50
1700 Convention Center Drive _
Miami Beach, Florida 33139 - i I Y
www.miamibeachfl.gov
City Clerk's Office
Tel: 305-673-7411
Fax: 305-673-7254 S Office Use Only
004- 02 ,L- S , 01/
ANNUAL LOBBYIST REGISTRATION FORM
Name: L '1
Business Name: 5\ -€- C kb Prc?-4-
Address: •6 0° lor ok 5 o\N �d'tl� , ! Sri �d�or-, 1■..) 1/4 / ,V Y 1 d oo2a
Office Telephone Number: °212 3°°
Cellular Telephone Number:
Email Address: L G v C c-0`1 . C,op*l
If more than one lobbyist, please list:
1) Thor 5 ECaz - e C.>(2wt.
2) OSvl,t-vo\_ :S S'e/15�2;v� t ., U/% I sszil 51-�i v P L c '• L
3)
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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#: I-11 d` 05
Amount paid: 1 S oo . O a Date paid: �— SO - !L9
Processed by: -JA'SoN) 5/h..-v i . Date: � [ 3o - R„,
F:\CLER\SALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx
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