Italbuilding, Inc/Johann Barata
~
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City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: dtyclerk@cLmiami-beach.f1.us
LOBBYIST REGISTRATION FORM
(City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
o Check Box if an Amendment
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NAME OF LOB8YIST: (Last) (First)
7 4-t?C? ~w /4/ Te..y-".. Mt'aHf; FL.
BUSINESS ADDRESS: (Number and Street) (City) (State)
7.%-Z4-:2--f$~'1.$
FAX NUMBER:
(M.!) DATE QUAUFIED AS LOBBYIST
7~6- ~~- ~~'1~
TELEPHONE NUMBER:
"73/!?~
(Zip Code)
V !t;'u;rr~/h @
EMAIL: L-.2-A r~lfI-f~~
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I. LOBBYIST RETAINED BY:
NAMEOFJ.t~!b:i /J'7 t L~. / ~",h4'~Yl f3aY"",fA
~ 4t7 7W46 5+ M/llfm', F L
BUSINESS ADDRESS: (Number and Street) (City) (State)
7~g?- '?~/-~'7t/~ ~~3.z.I-Z~7
TELEPHONE NUMBER: FAX NUMBER: (Optional)
:??I44-
(Zip Code)
EMAIL: (Optional)
Fill out this section if prlndpal is a Corporation, Partnership or Trust [Section 2-482 (e))
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY:
. UST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTL V, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
III. CITY AGENCES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Relationship
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H~ne
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IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y,
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: 'f.7!? ot:? FeY f ~~vr
B} PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): *' 79. t:? C? r~V'" ~ dll yo-
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH 'EAR, 'EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTlNG 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 Section 2-482 of he Miami Beach City Code as amended, and all
reporting requirements.
Signature of Lobbyist:
, Z/'
Signature'of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
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~Produced ID
0,'4 I : FL "bL:# /)'~.
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o Personally Known
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
Signat
a
State of Florida, County of Miami-Dade
Sworn to and, subscribed before me
This I 'I day of OJ t9be.f" , 2002.
HIRAM DIAZ , '
NOrARYPUBUCSfATEOF FLORIDA
Print, stamp
FOR CLERK'S USE ONLY
Registration: D<f ACCEPTED [] REJEcrED
DATE:
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.J'
If rejected, state reason:
Registration fee paid: ~ Yes [ ] No I',
~ Cash [ ] Check MeR # ~
DATA ENTRY DATE: I 0 J ,~I () ~02
1 I
1 Flrst Revision - 05/17/02