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Deborah L. Martohue - T-Mobile South LLC (pkiLet.PSS con.-,�^wv .Cd-f,cr�S A, RECEIVEn '. !f i�'v 4I BEACH office of the City Clerk n I8APR 19 AM 11: 00 1700 Convention Center Drive H Y rT BEACH Miami Beach, FL 33139 r ihil. CITY C ERI", 305.673.7411 LOBBYIST REGISTRATION FORM Lobbyist means all persons employed or retained,whether paid or not, by a principal who seeks to encourage the passage, defeat or modification of any ordinance. resolution, action or decision of any commissioner, any action, decision, recommendation of the City Manager or any City board or committee;or any action,decision or recommendation of any City personnel during the time period of the entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the City commission, or a City board or committee. The ten) specifically includes the principal as well as any employee engaged in lobbying activities. The term'Lobbyists"has specific exclusions. Please refer to City Code Chapter 2,Article VII,Division 3,entitled'Lobbyists,' for additional information Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee,to the Office of the City Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular section, you must write "none" or -Ma' in that section. Any change to any information originally filed, or any additional City Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form. The lobbyist has a continuing duty to supply information and amend the forms filed throughout the period that the lobbying occurs. Separate registration forms shall be required for each principal represented on each specific issue. I. LOBBYIST INFORMATION: Martohue Deborah L. NAME OF LOBBYIST (Last) (First) (Middle Name) Martohue Land Use Law PA 1036 23rd Avenue N., St. Petersburg, FL 33704 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (Slate) (Zip Cole) 727.256.1211 727.460.8431 dmartohuelaw@outlook.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Greyvensteyn Armand NAME OF PRINCIPAL (Last) (First) (Middle Name) T-Mobile South LLC trade name T-Mobile 1300 Concord Terrace, Suite 200, Sunrise FL 33323 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 954.514.8084 954.663.7325 Armand.Greyvensteyn©t-mobile.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2482(c): • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(if none,write N/A): .ve SEE • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write N/A): publicly traded company on the DOW symbol TMUS Page 1 of 5 2 III. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specific description where applicable of a pending request for proposal, invitation to bid,or public hearing number. legislation regarding wireless communications facilities IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said City Commissioner or City personnel from 12 months preceding such commencement of service with the City to the present date,stating the general nature of the subject contractual relationship. Full Name of Individual and Contractual Relationship(If yes,explain) YES NO Title of Person to be Lobbied _ City Attorney, Deputy City Attorney, Assistant City Attorney X Mayor&Commissioners as may be necessary X F Pursuant to City Code Section 2-482(g), every registrant shall be required to state the extent of any business, financial, familial or professional relationship, or other relationship giving rise to an appearance of an impropriety, with any current City Commissioner or City personnel who is sought to be lobbied as identified on the lobbyist registration form filed. List any Business, Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write N/A): N/A V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION— Be Specific. (Note that a contingency fee Is prohibited pursuant to City Code Sec. 2-485.3): $450/hour Page 2 of 6 The following six(6)questions MUST he answered: 1) Pursuant to City Code Section 2488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": _Yes&No: Are you lobbying on a Present or pending bid for goods equipment or services.or on a present or pendino award for goods.eautoment or service? 2) Pursuant to City Code Section 2490,entitled Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": _Yes XNo: Aro you lobbying on a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the COY;Future Land Use Map? 3) Pursuant to City Code Section 2482(h), any person (except those exempt from the definition of"lobbyisr as set forth in Section 2481)who only appears as a representative of a not-for-profit corporation or entity without special compensation or reimbursement for the appearance,whether direct or indirect to express support of or opposition to any item,shall register with the city clerk as required by this section,but shall not be required to pay any registration fees. _Yes XNo: fie you representing a not-for-profit corporation or entity without special compensation or reimbursement? 4) Pursuant to City Code Section 2481, the term "lobbyist"specifically excludes the following persona: Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct, indirect or contingent to express support of or opposition to any item;and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. _Yes XNo: Are you providing only scientific. technical or other specialized information: appearing as a representative of a neighborhood association without special compensation or reimbursement of representing a not-for-profit based organization for the purpose of requesting a want without special compensation or reimbursement? 5) Pursuant to City Code Section 2491(1). no campaign consultant shall lobby the City Commission for a period of 12 months following the swearing in of any elected official(s) for whom the campaign consultant provided campaign consulting services within the past election cycle.See Section 2491 for more information. _Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission within the oast election cycle?If yes.please list the incumbent members)of the City Commission: _Yes_No: If ves. has it been less than 12 months since the elected officlalisl whom you provided cempaian consulting servicsa vies sworn In? 6) Pursuant to City Code Section 2482(a)(e)a.. a lobbyist who has within the past election cycle provided campaign consulting services to an incumbent member of the City Commission (which lobbying activity is not otherwise prohibited by Code section 2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular service before lobby the City Commission at a public meeting. _Yes XNo: Have you provided campaign consulting services to an Incumbent member of the CIN Commission within the past election cycle?If yes.please list the incumbent member(*)of the City Commission: _Yes No: If yet were y0u Promised or did you receive economic consideration in *oohings for Campalon consultina services? TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee: \ Ye*f ]No Amount Paid$ %`SO MCR a 141-00 b$ Date Paid 09.?A-1S( Lobbyist Registration Form received and verified by: 1 A"WJ S ..4flOA F:\[LER\SALL\aFORMS\LOBBYIST FORMS\Lobbyisf Registration Form Revised 01-01Qe REG.doc Revised 01/01/2018 Page 3 of 5 VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR. EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES. AS WELL AS COMPENSATION RECEIVED, FQR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED TO LOB- . A STATEM NT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE ORCOMPENSATfl DU-1 PO' /'ERIQD.' e 0 Signature of Lob.yist: /-s1 Debora L. Mart.'ue, E-..,AICP / I do solemnly swear or affirm that all of the foregoing facts, statements, and disclosures in this form are true and correct, and that I have read or am familiar with t r. 's ,ns .main-x in Chapter 2, Art. VII, Division 3, entitled "Lobbyists' of the Miami Beach City Code and alter`-.0%'=me s. / c- Signature of Lobbyist: —a y/ir,�,/ • �I Date o - �'/ 0 Des...- .artoh.e, Esq.,AICP Signature of P ncipal: / a- Date r Ar- .nd —ire n VII. NOTARY SIGNATURE AND SEAL: LOBBYIST:: PRINCIPAL State of f `ort''/ State of Florida County of:'-P'v` r I A S County of: Broward Sworn to(or affirmed)and subscribed before me Sworp4 (or affirmed)and ubecribed before me this /./" day of Ri/1 20,1g by this/�"C5y of /�JJ/'i L 20_)8 by NAME OF LOBBYIST Deborah L. Martohue NAME OF PRINCIPAL Armand Greyvensteyn _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION ✓- •natty Known ✓ P ovally own Attreof& ry !Iic ure of, -ry •ublic SgnlfNotary �Publ/ic 71 7 IC( pY/ygNyz ame of Notary,Typed, Printed or Stamped Name of Notary,Typed,Printed or Stamped ,+yr.: , PATTI SCOTT it„�;; (NOTARY SEAL) A '= Commissbnp FF 232118 (NOTARY SEAL) }L'€, *yr,; DENISE RODRIGUEZ MY COMMISSION FOG 084538 ;�-Rr,%`” Expires September x. mmn if E%PIREe:MarUt8,1021 , Nf,;..,,`' ao+4tllhry Wby PublcUMVYes `The term lobbyist specifically excludes the following persons: r Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct,indirect or contingent, to express support of or opposition to any item, and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance Page 4 of 5 • /. 1(\ I BEAC !- City of Miami Booth, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeacM gov Office of the City Clerk Rafael E. Granada,City Clerk CiyClerkOmiamibeachfl.gov Tel: 305.673 7411,Fox:305.673.7254 NAME OF LOBBYIST: Deborah L. Martohue, Esq., AICP Martohue Land Use Law P.A. 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement (Statement). In addition to any other penalties that may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements filed after the due date. The City Clerk shall notify the Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th of each year, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a signed Statement under oath listing all lobbyist expenditures, as well as compensation received, for the preceding calendar year with regard to the specific issue on which I have been engaged to lobby. 2) LOBBYIST WITHDRAWAL Once an issue I have registered to lobby has concluded or I am no longer lobbying on that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk. 3) ANNUAL LOBBYIST REGISTRATION FEE I understand annual registration of all lobbyists shall be required for each 12-month period commencing 0 tober 1 of each year, and the fee for such annual registration shall be $500.8• purs i t e .e ion 2 • he Miami Beach City Code. -,,((, _ eVg 4/U /Signa ure of Lob>tSyYst Date F CLERaALLUFORMStOOBYIST fORMBWEbyIst RgW.EW Fpm RMxt 01.01-18 REG ex Page 5 of 5 1Mi BEACH RECEWE-) City of Miami Beach 2010 APR 19 AM 11: 00 1700 Convention Center Drive Miami Beach, Florida 33139 -.11 f11) ;Ilr. CITY )ERG www.miamibeachfl.gov City Clerk's Office Tel: 305-673-7411 Fax: 305-673-7254 Office Use Only ANNUAL LOBBYIST REGISTRATION FORM Name: Deborah L. Martohue, Esq., AICP Business Name: Martohue Land Use Law PA Address: 1036 23rd Avenue N., St. Petersburg, FL 33704 Office Telephone Number: 727.256.1211 Cellular Telephone Number: 727.460.8431 Email Address: dmartohuelaw@outlook.com If more than one lobbyist, please list: 1) 2) 3) 4) 5) 6) 7) Submit this form to the Office of the City Clerk, along with a check for $500 for each lobbyist. Please make the check(s) payable to the City of Miami Beach. For City Clerk's Office Use Only MCR#: tlZQ�o�4' p( Amount paid: uSO CC Date paid: 011-191-(1 Processed by: - . So�, ^-c-t-vc¢- Date: °C{ i cT - / D F\CLERISALLIaFORMSLLOBBVIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg dou Salvatore, Jason From: dmartohuelaw@outlookmm Sent: Thursday, April 19, 2018 11:15 AM To: Salvatore, Jason Subject: CEO disclosure supplement to Lobbyist Registration -Deborah L Martohue Attachments: T-Mobile CEO & GOD 4-19-2018.PNG Jason Please see attached and let me know if that will suffice. Thank you Deborah L. Martohue Esq., AICP Martohue Land Use Law PA 1036 23rd Avenue N. St. Petersburg, FL 33704 Office: 727.256.1211 Mobile: 727.460.8431 Email: dnsartohuelae'iibullook.Com Please note new address and phone number and update your file contacts. Thank you. PRIVILEGE AND CONFIDENTIALITY NOTICE:This e-mail is the property of Martohue Land Use Law P.A. It is intended only for the person or entity to which it is addressed and may contain information that is privileged,confidential,or otherwise protected from disclosure. Distribution or copying of this e-mail, or the information contained herein,to anyone other than the intended recipient is prohibited. If you have received this e-mail in error,please immediately notify the sender by e-mail at dims llifillelis+n outlook con) or telephone at 727-256.1211. Please delete and destroy any copies of this e-mail. Please consider the environment before printing this email. Thank you. 1 .:pr,. Pi :Jilt i ' 'I _`- Company Overview of T-Mobile US, Inc. .iir Snapshot ar1v =sn lirtF ;..W =T, ` Pi V,` Overview Board Members Committees A__T k. i Executives For T.Mr: O,' I.` Name Board Relationships Title Age John J. Legere 79 Relationships President. CEO & Director 53 J. Braxton Carter II 11 Relationships Executive VP E,CFO 53 G. Michael Sievert 25 Relabcnships COO S. Director 46 Thomas C. Keys No Relationships President e`MetroPCS Corrmunications. Inc 53 Jeffrey T. Binder 2 Relationships Executive VP Howie S Entertainment -- View More Key Executives 1-•,lohile Us, Inc. Board rd,-c i;.,., BoaName Relatilonships Primary Company Age Timotheus Hottges 39 Relationships Deutsche Telekom AG 55 John J.Legere 79 Relationships Deutsche Telekom AG 5.3 G. Michael Sievert 25 Relationships Mobile US. Inc 46 Srikant T.Madhav Datar 57 Relationships ICF International Inc 64 Ph.D. Teresa Ann Taylor 40 Relationships First Interstate Bancsystem Inc 53 View All Board Members '. )-but: US, Inc. Fxear. . r n, ii Committee Name Chairperson Board Relationships Members Audit Committee Ph.D. Srikant T. Madhav Datar 57 Relaflonships 2 Executives Compensation Committee Teresa Ann Taylor 40 Relationships 4 Executives Nominating Committee Kelvin R.Westbrook 79 Relationships 2 Executives Corporate Governance Committee Kelvin R.Westbrook 79 Relationships 2 Executives Executive Committee Timotheus Hottges 39 Relationships 6 Executr;es View Committee Details "I .it.i is atleastascuvrr` � - , r nl F.. x , '' a Sri . 4S� a ..a oe a"k v s, 'fit*a ..�t ' 1 191V 1C pq� O m m om o n � 1 N �a a a � o p o - C 0 C) se.I 3 N . 0 C 1 S o o (7co i I\ (Y