South Beach Ocean Parcel
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City of Miami Beach OffIce of the City Oell<
1700 Convention Center Drive, Miami Beach, FL 33139
Emall: dtydell<@d.mlami-beach.fl.us
LOBBYIST REGISTRATION FORM
(Oty of Miami Beach, aty Code Chapter 2, Division 3, Section 2-481)
.15 Check Box If an Amendment
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NAME OF LOBBYIST: (Last)
toloo
(M.!) DATE QUAU~ED AS LOBBYIST
,::t. 3~13
(Zip Code)
ixU. to-hJb..u .&r,.,
EMAIL:
(50$') 53(,- H Co2
TELEPHONE NUMBER:
(aty)
BoS') .<)3b- l\ \10
FAX NUMBER:
L LOBBYIST' RErAlNED BY:
~1)dQ.:.h Pua..-eh ()~ ~o.JW. Idd - do ~ &IJ.~ ~1~Jl.1'
NAME OF PRINOPAl/CUENT:
~ (P'1 ~~ a.t1.t ftU-Q..
BUSINESS ADDRESS: (Number and Street)
j 'I.f~ ~( I n~lot ~ ~/c }t)CO 100.;)l
(City) (State) (~iP Code)
TELEPHONE NUMBER:
FAX NUMBER: (Optional)
EMAIL: (Optional)
FIll out this HCtIon If prtndplll Is B CorpaI'IItIon, PlIrtnenhlp or nu.t [SecIIon 2-482 (e)l
? NAME OF CHIEF OFACER, PARTNER, OR BENEACIARY:
W dr; Rrru <?L .$..ctw/
UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARJNERSHIP OR TRUST:
~ ,tj; .eilN/
D. SPECIFIC LOBBY ISSUE:
m. ClT'f AGENCIES/INDMDUAlS TO BE LOBBIED:
A) Full Nllme f111lndlvlduBI{I1tIe
B) ReIBIIoIRlp
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSA110N (DISCLOSE WHE11tER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE:
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B) PRINCIPAL'S DISCLOSURE (O~~~OMPENSATION):_ ~
e'V\
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v. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR. EAOt LOBBYIST SHALL SUBMIT TO THE CITY CU!RK A SIGNED
STATEMENT UNDER OATH, LISTING LOBBYING EXPENDnuRES IN THE CITY OF MIAMI BEACH FOR
THE PRECEDING CALENDAR YEAR.
I do solemnly swear that all of the f egoing facts are true and correct and that I have read or am
familiar with the provisions con . e in S ion 2-482 of the Miami Be City Code as amended, and all
reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFlCA110N:
15 Producecl ID
Form of Identification
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YD. SIGNATURE AND STAMP OF NOTARY OR DEPUIY a.ERK:
State of Florida, County of Miami-Dade
Sworn to~d sUbscribfd ~D~~e me
This 10 day of ~ 2002.
ry - State of Florida
,..; ~ EIIzabel/I BernardO
Print, sta~~"ry Public
FOR CLERK'S USE ONLY
Registration: [] ACCEPTED [] REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No
[ ] Cash [ ] Check MCR #
DATA ENTRY DATE: 2002
1
1 First Revision - 05/17/02
IV. bJSCLOSllRE OF TERMS AND AMOUNTS OF LOIIBYIST COMPENSA'IIOtI (DISCLOSE WHETHER HOURLY,
Fl.ATRATEOR. OTHER~
A) LOBBYIST DISCLOSURE:
-.....funu 0 (f ~ S'~ s.,oo
B) PRINCIPAL'S OJSCLOSURE (OF LOBBYIST COMPENSATION): ~ 6'Y'- LtA Wl~ i:Jg ~
Y. SlGllAlURE UNDER ~tH:
ON ocroBER 1ST OF EACH YEAR. EACH LOBBYISI' SHAI.L SUBMIT' TO THE CLERK A SIGNED
srll.TEMENT UNDER OATH, LISTING LOBBYING EXPENbrruRfS IN THE OF MIAMI BEACH I"OIt
THE PRECEDING CIl.LENbAR YPR-
Signature of Pr1ndpaI/Client:
VI. LOBBYlST IDENTJI'ICATtON:
. PruducedID tofl;:t, T2 1J-lW~~~ ~,lM
Fa o1tdentification c5?t ~
d that I have read or am
City Code as amended, and all
I do solemnly swear that all of the
familiar with the provisions con .
reporting requirements.
Signature of Lobbyist:
" Personally Known
YD. SlGJtAlUU AND sr""P OF NOTARY OR DEPUTY ClERIC:
State of Florida, County of Miami-Dade
Sworn to and subscribed before me
This day of J 2002.
Signature of Public Notary - state of Florida
Print, stamp or type name of Notary Public
FOR CLERJ('S USE ONI. y
Reglstr~tion: [] ACCEPTED [] REJECTEO DATE:
If rejected, state reason:
ltegistratlon fee paid; [ ] Yes [ l No
[] sh [ ] O1eck MeRit
DATA ENrR.Y DATE;
1
2002
ENTEREO BY:
I First ~15ign - 05/17/r:12
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STATE OF FLORIDA, COUNTY OF MIAMI-DADE
SWORN TO AND SUBSCRIBED BEFORE ME
TInS ~ DAY OF 0'1#1"r- . 2002.
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Print. stamp or type name of Notary Public
KIIIHRYN Eo 8M.VEMINI
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