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Lastra, Aldo m City of Miami Beach Office of the City Oerk 1700 COnvention Center Drive, Miami Beach, FL 33139 Email: dtyclerk@ci.miami-beach.fl.us LOBBYIST REGISTRATION FORM (City of Miami Beach, City Code Chapter 2, Division 3, SectIon 2-481) 6 Check Box if an Amendment NAME OF LOBBYIST: LA S\tZ.A (Last) 2420 5W A L-f)O (Rrst) qq cr. ~{tWl, PL- ' (Number and Street) (City) (State) .3:l~ zzS"- 5'1 qg AX NUMBER: (M.I) ,}Jer I. LOBBYIST RETAINED BY: ~ELr NAME OF PRINOPAl/CUENT: BUSINESS ADDRESS: (Number and Street) (City) (State) (Zip Code) TELEPHONE NUMBER: FAX NUMBER: (Optional) EMAIL: (Optional) Fill out this section if prlndpal is. Corporation, Partnership or Trust [SectIon 2-482 (c)) NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: UST ALL PERSONS HOLDING, DIRECTlY OR INDIREcrL Y, A 5% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: II. SPECIFIC LOBBY ISSUE: ISSU::OO!~~!1~~;;tail):VOwPp{27 1JJ9J/2.6tJa feJerrfS IU. CITY AGENCES/INDMDUALS TO BE LOBBIED: A) Full Name of Indivldual/TIUe B) Relationship IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL Y. FLAT RATE OR OTHER): A) LOBBYIST DISClOSURE: LoB671~ \<? NJ ItJ.Q)UtJCE ~'7Jf MJr? WiLL- e,e rMf'aJSb-~-o /31' <(f.oUvtI Gs(OIJ~ (!)~ 11-f& SA ce5 Of [J.J 9JJ2MJce: . B) PRINCIPAl'S DISCLOSURE (OF LOBBYIST COMPENSATION): Y" - As A L06gYI~ IJD C<>I.-1PtaJ:;A~. AS A PRrtiJaA4L- 5.: 1 r&>HfEIJ~OSl If; A f8Z~ 0:. S',4te5J. ~5e:O _ V. SIGNATURE UNDER OATH: Q p.~JJ~ ~l&"~ [37' fJtC.Cf'T'T. ~ VAP-7' I~% ~l? 40%. ON OCTOBER 1 sr OF EACH YEAR, EAC LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTING 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 the Miami Beach City Code as amended, and all reporting requirements. Signature of Lobbyist: a~ ~~ Signature of Principal/Client: VI. LOBBYIST IDENTIFICATION: . Produced ID f:bL- - L ;)..-:st-, - (')l57'J - 55' - 37 S--- 0 Form of Identification . 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 d-,vcA. day of ~2002. OTARYSEAL LJLLIAN BEAUCHAMP NOI'AKYPUBUC srATE OF FLORIDA COMMlS510N NO. DDl09289 MY COMMISSION EXP. ~~?.2006 FOR CLERK'S USE ONLY 4 rz, Registration: [~EPTED [] REJECTED DATE: I ~/.2--/tJ 7.- If rejected, state reason~. ,. )l1~ Registration fee paid: ] No _'J 7/3 C7 sh [ ] Check MeR #C/rl~ I C) '5 7/~ DATA ENTRY DATE: 1 .2002 ENTERED BY: I First Revision - 05/17/02 \..