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Echo Complex dba Echo Unltd. >-. ~ ~.~j. ~' ~v in City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, FL 33139 Email: dtyderk@d.miami-beach.fl.U5 LOBBYIST REGISTRATION FORM - (City of Miami Beach, City Code Chapter 2, Division 3, Section 2.481) o Check Box if an Amendment NAME OF LOBBYIST: lu-~ ( A- (First) (M.I) DATE QUAUFlED AS L088YIST F. lU...1 BUSINESS ADDRESS: ~VbO~ -07 ( 7 I. LOBBYIST RETAINED BY: EC~ . (Y)MP~ NAME OF PRlNOPAl/ ENT: ~g2 EMAlL: (Optional) Fill out this section If prlndpalls a Corporation, Partnership or Trust [SectIon 2-482 (e)) . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: . UST ALL PERSONS HOLDING, DIRECTlY OR INDIRECTlY, A S% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: ~och ~ II. III. CITY AGENCIES/INDMDUALS TO BE LOBBIED: A) Full Name of Indlvldual/TItle B) Relationship ,. t!tfvJ r. .-(" IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y, FLATRATEOROTHER) A) LOBBYIST DISCLOSUR~ '1 s{), 00 fJ.eif h (N l<..- v B) PRINOPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): ~D()r 00 ~ ft..cJ LJ /' V. SIGNATURE UNDER OATH: ON OCTOBER 1 Sf 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 contained in Sectio -482 of the Miami Beach City Code as amended, and all reporting requirements. Signature of Lobbyist: Slg_"'ofPri"dpaVd~"" ~~ ~~ VI. LOBBYIST IDENTIFICATION: o Produced ID Form of Identification o Personally Known VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK: State of Florida, County of Miami-Dade Sworn to and subscribed before me This day of . 2002. Signature of Public Notary - State of Rorida Print, stamp or type name of Notary Public FOR CLERK'S USE ONLY Registration: [vI'ACCEPTED [] REJECTED DATE: ~, S! O"Z.... If rejected, state reason: Registration fee paid: M Yes [ ] Ny [ ] Cash [VJ Check MCR # -z.,4\.f S'Z. ~ DATA ENTRY DATE: 1 .2002 ENTERED BY: 1 Rr5t Revision - 05{17{02