Wayne Pathman/63rd St Assoc.
m
City of Miami Beach Office of the City Clerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: cityclerk@ci.miami-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
Pathman, Wayne M.
NAME OF LOBBYIST: (Last)
(First)
(M.I) DATE QUALIFIED AS LOBBYIST
2 So. Biscayne Blvd., Suite 2400. Miami
BUSINESS ADDRESS: (Number and Street) (City)
FT. 33131
(State)
(Zip Code)
305-379-2425
TELEPHONE NUMBER:
-:tnl:\ -:t7Q ?A?I)
FAX NUM8ER:
EMAIL:
I. LOBBYIST RETAINED BY:
N~M11,~ P~~Cfp~~eLIEMSGlcia tes, -Ltd,
. . / .. . .. ~.! " '
1fi3? P~n~Rylv~ni~~v.nl1~. M1~mi R~~~h FL 33139
BUSINESS ADDRESS:" .. (Number and Street) (City) . (State)
(Zip Code)
.,
j ,'~,
-:tnJ:\ 1:\':11 Q"7QO
TELEPHONE NUMBER:
10~ ~11 91Q2
FAX NUMBER: (Optional)
EMAIL: (Optional)
Fill out this section if principal Is a Corporation, Partnership or Trust [Section 2-482 (c)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFIOARY:
Craig Robins
. LIST ALL PERSONS HOLDING, DIRECTlY OR INDIRECfLY, A 5% OR MORE OWNERSHIP INTEREST IN SUCH
CORPORATION, PARTNERSHIP OR TRUST:
Craig Robins
.... '
II. SPECIFld.OBBY ISsUE:
Hi-' .-.'. ',".. ". - .
Cond-it.ion,a,1tJ~~'Pf'rm.it: -Fnr ,...nn~""rn""""';nT'l n-F nn......1ra
Issue to be lobbilld (Describe in detail):
" it,fi ;'~;
,.
III. CITY AGENClES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title B) Relationship
. ..
.,-,"
Planning Board
IV. DISCLOSURE OF TERMS AND AMOUNTS OF LOBBYIST COMPENSATION (DISCLOSE WHETHER HOURL)j
FLAT RATE OR OTHER):
A) LOBBYIST DISCLOSURE: $260/195 h01lrly
V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE crrv CLERK A SIGNED
STATEMENT UNDER OATH, LIsnNG 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 contai 'n ection 2-482 of the Miami Beach City Code as amended, and all
reporting requirements.
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
o Produced 10
Form of Identification
~ Personally Known
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
S~orn to p'~ubscri~~e ,.c;:>
This )2. day of oJ 20lJb
FOR CLERK'S USE ONLY
Registration: [] ACCEPTED [] REJECTED DATE:
If rejected, state reason:
Registration fee paid: [ ] Yes [ ] No
[ ] Cash [ ] Check MCR #
DATA ENTRY DATE:
1
.2002
ENTERED BY:
I First Revision - 05/17/02
SEP-2g-03 04:10PM FROM-PATHMAN LEWIS,JIP
305-m242O
T-8g6 P.04l05 F-808
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~Ity of MllI/TJlllIlCh 0IfiI;e(J( thll Cty '*~ .
1700 ClltMln~O/l CIntIr 0rI\III, Miami &eac:h, R:. 331:\9
~aH: C1tyder'1cOcl.mlamH",lICt1./'1.jlS
I.OBSYJ51' ReGISTRA'TlON FORM
COty pf MIami Suc:h, CIty PIlle CMptllr 2, PlvlSlon 3, Sectloll 2"'1S1)
~. Check SOX If an Amandmant
!?BthDllln, Wayne
1'W1l! OF I-OS8VIST:
2 So. Biscayne
SUSlHW AOP/if5.5:
305-379-2425
n:U:PHONe NUMlleR:
M.
(LaS[)
Blvd., Suite
(Number and StmtJ
(First)
2400. MfBmi.
(ClM
(M.I) DA~ QUAUfXSD AS!LDBBYIST
Ji'T. ~!t1 '::11
. (Srate)
(ZIp Code)
~I'\P;:: '::1"70 "'4"0
FAX NUMBE!l.:
Et1AIL:
x.. /.Q811YXS'T RETAJN~ 1m
~o1p~"rLFM!sr;lobtes,:"Lt" .
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'R~'- J'oIDn;'';',,'Vlln4R "'U'.t"l;,~. v.(.",,, 'J:IoO!:I"'J;J
IIUSINess ADDReSS:' . . CNumll8r and ~t) (Oty) ,
".. t Ii. '; :~. ,," ,'''. ..'''' ' '. "
'2n"-:;_~"1 Q"7nn
TaEPHCN~ NUMBeR;
Jilt, { '311 '19
Stara
(Zip CPde) :
':2nlj ..~ fi~Q~
FAX NIJ BERI Op anal)
&1AIl.: (PptIanaj)
I'illlmtthJ. Ncthm" prIndpa/" I Corpo"1ltlO", Partnership arT",..t [liIIctlD" Z-48Z (l:)]
HAM!! OF cHIar. om~, PARTNER, OR B!:Nl!I'ICARV:
Craig Rogina
. lJliT' AU. peRSONS HOLDING, DIRI:CTJ,.Y Ofl. INDwcrl-V, A 5'11> OR MOR! OWN!RSHII' II'mRfST IN SUCt;!
CO~1jON. PAATNERSHIP OJ{ TIlUST:
Craig Robins
...... '.. ".
. :0. 5P1!c:nc ~t:o'8Y ISSUE;
aorid:r~:"{~n,,"'~':rj.,. P."'~'; +." fn~ ,.,'It=JA....1'''',,,......f 1"\'" ,.,.,fI ,.11"\1''''''.
l5iIllltIJ ~.'f1J~~ (~/ltl ~ ~~J):' .
'ri"
:02. erN AGI!NCJE.S/INDMQUALB TO B& LOBNED!
A) """ JIIl111'1e of IlIdIvlduaJmtl. B) RelationAl" .
..
Planning Board
1
SEP-Z8-03 04:10PM FROW-PATH~ LEWIS,JIP
3D5-3T8Z42D
T-B86 P,05105 F-BOB
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Fl.Il T ft4Tfi 0/1 OTHER)!
A) ~DISCl-OSuR2: ,,,,."/1 QIl;
P) PlUNOPAL'S PIS~!(OF I-OllllYl5TCOMPfNSATlONl: ~ Ofl C;~
./
,
Pursuant to Ortllnanr.e No 2003';'33g~ Amendlno Miami Beach Oty Code ChaDtel' 2. Article VII. DlYlsI~
Thereof Entltll!d "Camoalon FlnallCl! Rererm~ Via The ArJdltJon qr Codl!! <:Arlien 2...88 Enlitled "Prohlb~
pmoaian CnntrlbutiOIl!ii By Lobbvlsf!; On Procurement I5SU8S"~ .: I
:~~I~~dQ~:~~~I::'':'~':::rc:Re~or-'''-' DrOll a o~nr
2) PurslJant to Ordll)ance No. 20034395 Amendlno Miami Beach City Code ChaDtel' 2. ArtIcle VII DlvIslOn!!i
tbsreor Entitled "Campalon FInance RB'orm~r Via The Addition Of Cede SectIon ~049a Entitled "Prohibited
Cammion Contrlbut:lons BY lobbYIsts On /lRal Est.at.a DeveloDment Issues": ' ,
, ' ,
, 1
~;m~~ :"'bbvln~ an ill oendlna a_Jlcatlan for a DlMIIlaDID!IJllAgl'88111ent wlth,the Citv a. i '
1II~=-- ~!!,nae of zonlno maD desiDnatlan or malKle to t!le Cltv's putu.... Land Use;M~a7
, '
, ,
V. SJGNA'JUlIE UNpj;!l 0A1H: ; I
I
ON OCTOIIER 1" OF EAt" YEAR, EACH LOBlMST SHALL SUBMIT TO THI! CJTY q.ERK'" SlGNI!D : 1
STATP4Srn' UNDER OATH, LISTlNG La"BYJIIlS JlXPI!NDITURES IN THIl cnY OF MIAMI BEACH Fa.
THI! PRECIlPING CALENDNt ytlAR. ,
!)
Form of Id!ntllicatlon
VII,. IilGHATURI! ANP &TAMP at' rtmAJr:t 0/1. DIPUJY Cl.GK:
State of Aorldi5, county of Mlam~Dade
SWorn to 1100 subscribed before me
This 29th day of ~tenb~
'acts are true and c:arrect and that I have read or am ' ;
o 2-482 of ttJa Miami l:lalll:h CItY Cpde as amended, Itld! all
63'" Street AsSOCiates Ltd.
I do fiQlemnly swear thllt all of the foregoln
'amlllllr with the provisions lXIntaln I S
reporting requirlilments.
*Slgnature of I.ObbYIst;
... " Signature of Principal/alent:
VI. LOllBYPlT~
C Produced 10
~~,
fOR c:LERK"S use ONLY L /
~IIDm AClVT!P/~ I ] IWI!CTEO /.~ ~~, 03
~nf:;.:n:rl []No t lcaoh~1CI< MCIt~,~f."52,q ,
PATAeNlJl,VPI\Tf: ? ~0 2003 fHTERfDUY: ~,L , i
2nd ~llI1 3/1B/03 f :\CU! :n-lJ.DbbyI5CS~03~
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