HomeMy WebLinkAboutMurano Three, Ltd.
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: cityclerk@ci.miami-beach.fi.us
LOBBYIST REGISTRATION FORM
-
(City of Miami Beach, aty Code Chapter 2, Division 3, Section 2-481)
i:l Check Box if an Amendment
JO-H-W
(First)
4"Z-
(M.!) DATE QUA I AS LOBBYIST
BUSINESS ADDRESS: (Number and Street)
2 1$clv''- Jwc.-K ~c.P~'f
(aty)
U 'IlJ ~o 'tt/
(State)
(Zip Code)
I.v I.
TELEPHONE NUMBER:
i+ un oatil 0 LOO
I. LOBBYIST RETAINED BY:
FAX NUMBER:
~ ~l 00"1 02.00
EMAIL:
..\ok",~ YDDa.>'E:-~. Co,,",
....!1 /11 (A lV 11
NAME OF PRINOPAl/CUENT:
T.J1::Q5 f
(d,
(Number and Street)
vtcl
17-1.- 5"
AI- ~w
t111~1
(City)
~~
Fc..
':)") l'}4
(Zip Code)
BUSINESS ADDRESS:
(State)
'$OS' 674- ~i()
TELEPHONE NUMBER:
~a> 604- 8'014-
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal is a Corporation, Partnership or Trust [Sectlon 2-482 (c)]
. NAME OF CHIEF OFACER, PARTNER, OR BENEACIARY:
UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
II. SPECIFIC .L.OBBY ISSUE:
~{f:$ttJTtttll>W,ll"CAif 'oF
Issue to be lobbied (Describe ihdetail):
i~ P.\:J tl)C. ~ G-~~ ~..II.
III. CITY AGENClES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Relationship
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURLY,
FLA T RATE OR OTHER):
A) LOBBYIST DISCLOSURE:
L4fJ fM
B) PRlNCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
ILloD 01.h.J ~
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v. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR.
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 co ined in Section 2-482 of the Miami Beach City Code as amended, and all
reporting requirements.
Signature of Lobbyist:
SI,nowe. of p"Odpeva~Ot::,j'r-)" .~
VI. LOBBYIST IDENnFICA . : .
,~~
f
CJ Produced ID
Form of Identification
~ Personally Known
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn to and SUbscrr m,e
This J g>' day of 2002.
/
FOR CLERK'S USE ONLY
Registration: ~CEPTED [] REJECTED DATE: ~- [~-Ud-
If rejected, state reason:
Registration fee paid: r1 Yes [ ] No
[ ] Cash [ ] Check
DATA ENTRY DATE:
1
200"":'~~~~1,
I First Revision - OS/17/02