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General Real Estate Corporation Dec. 9. 2002 9:15AM Pardo & Gainsburg, LLP No.0021 p. 7 , CIty d Mmi IItIdI 0II'a Df lIlI CIty CIIIk l700 CIIlWWll10n c.ar DrIve, MIMlI -.ch, PL 33119 !lYt: clt,IclIItlOd,mlamI-bIIch,tI.UI LOIIYZST RIGUTRAnON PORN (:;E1VED 02 DEe ..9 Mil I: 3"1 CITY cLEi{\":S OFF ICE lD ,.,. h (CIty or M.m1 !ltIch. CIty COd. Chl~r 2. PIYt1IIon 3, Stetlllll 2....1) . Check lox If.n AlMndment /irr,qn /J~;/] NAME OP I.OBmST: (1Mt) Ill). 9500 _<;w , sr In flJ/Y11 BUSINESS ADOR!SS: (Number InCl Str'IIl) (Oty) ($Me) TEl.EPHONENU~5 -c:J(n). -(Pif'NUH__~>S -,;)(p~ ~ '(,//3 (M,!) llo\TE QUAL.II'lED AS L088'I'JST P- 33 j '1'1 (ZIp COd.) 1!foWI.: I. L~IYISI' IlITAINIIJ IVI ~EJJ~l- ttttf-L. ~N7t"re:. &;tePOe.~(D,.j NAME O~ IUNClPAlJOJ!NT: esoo ~w f-K..fr. Ju.,.,t :2~P. Jf,I.,,,..,,, R- 8USIN!S$ ADDRESS: (NumbIr .J StreIt) (Qly)' (STD)' ~s- //'1.- '~3~ T!L!PHONI! NUM.R: 33/'1'1 (ZIp COde) FAX NUMIlER: (OpIional) EMAIL: (OptIonIIQ 1'111 OUC ..... Hdlan ., principe' II . corpol'ltlon, ...tMrIllllI or 'YnItt f'""" ....2 (c)] ~ NAME OF C:HI~ 0l'I'ICER, PARmER. OUENl!I'laARV: /I ~u.rf71J tI~lI^, , LIIr ALL fIEJlSONS tlOLDJNG. DlR!CnV OIlINDlRI!CTI.V, 1t.!l'lII OR MORE OWNERSHIP INTI!RESi IN SUCH CORPORAilON,'PAATN!IlSH1I'ORTlWST: 1+~u.rt/1tJ tts~ ~IUJ II. 1.l'tJ.LS m. cnT AftNC1U/1NDIVIDUALI TO R LONIIPl A) I'IIU N_ of lndlvlclllll",..' I) IlIIlItl_hIp 11 f) fI.e. ~ Dee, 9. 2002 9:16AM Pardo & Gainsburg, LLP No.0021 p. 8 . ' lV. DUCLOSUU 01' 1IRMS AND AMOUNTI OP LOSmfT COMI'I!NIATION (~IICLOII WHITHER HOU.L Y, I'LATIlA," 011 OTHW.)t A) LOlIIIYIST DI!iCI.OSUR!: n t1)1.(. fJb ~ 4-r pwt Ol- ~ '/1,n.~ ~f~~ ~ '''''''''' -... """"""""""""''' ~ *- - ~<ft~~~ Y. IllGlNATUltI UNDlII 0A'I1t1 ON ocro... I." OP EACH Y!AR, !ACtt LONYJSr SHALL SUlMlTTO THI! CITY CURl( A AClNID STATIM.NT UNMR. OATH, LIlTING LOIIIIYZNI IXI'INDlTURlSlN THE CITY 01' MIAMlIIACH POI. TN. 'RICIDING CALlNDAR YIAll. I do solemnly IWRI'that III of the fOregOing famlllllr with the provlllons contained In on reporting requirements, Signature of lobbyist: VI. . Produced ID Form of IclentItialtion ../Personelly Known VII. GINA'" AND fTAMI' OI"IIOftIlY OIl DII'U'I'I' CLIIUCI State of Florida, County or Miami-Dade SWOrn to4nd subJcrlbed before me This day of fJu. . 2002, ... ANAMARL'GUERAA MY COMMISSION' 00 Q23553 EXPIRES: AIJQllII29, 2OIl6 Boodf<\ 11lN No\lI'1 Publ~ u.../w- POR CL!RK'S US! ONLY Rlglltratlon: tiJ ACCEmD r) REJECTEI) DAT!: (2--q - V 11- If 1eJ1CtIId, ate 1'1lIOII: Reglsntlol'l ftt paid: My. [ ] No n~[]ChIck MCR' p."TA ~y DATE: J~t~ . zooz " I fIrIt R.IYIIIon - OIl17/r1l