The Setai GroupCity of Miami Beach Office of me City aerk
1700 Convention Center Drive, Miami Beach, FL 33139
Emaih dtyderk~)d.miami -beach.fi.us
LOBBYZST REGTSTRATZON FORH
(Oty of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
NAHE OF LOBBYIST: ('Last)
,(~irst) (M.I) DA'T~ QUAlIFiED AS LO.ST
BUSINESS A~SS: - (Numar and S~) (Ci~) ' ' (S~) ' '(~p C~e)
o oo 0/ o
~ONE NUMBER: F~ NUMBER: E~L:
NAME OF PR~NQPAL/CL[ENT:
BUS[NESS ADDRESS: (Number and ,~r~et) (aty) ~ (State) (zip Code)
L, ,t 't;1:
TELEPHONE NUMBER: FAX NUMBER: (Optional) ENAiL: (Op'donal)
Fill out t~is ~ if prlndpal Is a Corporation, Partnership or Trust [Section 2.482 (c)]
· NAME OF CHIEF OFFICER, PARTNER, OR BENEFiC~RY:
· ~ ALL PEP.SONS HOLDING, DIRECTLY OR [NDIRECTLY, A 5% OR MORE OWNERSHIP iNTEREST IN SUCH
CORPORA'r[ON, PAR3NERSPEP OR TRUST:
A) Full Name of l. dif~d,,.,Iflltl~ B) RelaUonship
1)
2)
· ' n I~II ' ' V '
~ i 'Vi "n ' n
Camoalan C~ntdh~,r~ns EN Lobbyists On Procurement
n . ? r r n
P ' ri' '
I M r · I M'n
· " ' Fin R f tm" V'a i' n ' n -4 0 n' "P hi i
CameaJan Contributions By Lobbyists On Real Estate Develooment Issues":
Are you Iobbvin~ on a .endinq ~__~.~.,'~Hgn for a Cc;-:::-=~6~ A~r-- :_~ with the City ~,,
= n ;--"-~ '~---~ .... ---/- - i ,
ON OCTOBER ~.s-r OF EACH YEAR, EACH LOBBY/ST SHALL SUBMTr TO THE ~, Y CLERK A SZGNED
STATEMENT UNDER OATH, LZSTZNG LOBBYING EXPENDTTURES ZN THE CT[Y OF MZAM! BEACH FOR
THE PRECEDZNG CALENDAR YEAR.
! do solemnly swear that all of the foregoing facts are true and correct and that I have read or am
familiar with the provisions containdd in Se~ioQ 2-482 o/the Niam Beach
Vi. LOBBYIST ZDENTI]=ZCAI~ON:
~ Produced TD _~_.~lV~l~'$LscE S Personally Known
Form of [d~nlJfication
State of Rorida, County of Miami-Dade
Sworn to and subscribed, before me
This ZH day of ~/~l~' ,2003.
Print, stamp or type name of Notary Public
If rejected, state mason: / / /
J ,2~3 E~D BY~ ~
2~ ~ 3/Z8/03 F:~C~R~ob~i~a~03.~