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Carlos G. Cardoso - Ministerio International El Rey Jesus lc'E"c ESE® M I AM I B EAC Fl Office of the City Clerk JUN 10 2020 1700 Convention Center Drive Miami Beach, FL 33139 CITY OF MIAMI BEACH 305.673.7411 OFFICE OF THE CITY CLERK • 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 term 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 "n/a" 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: Cardoso Carlos G. NAME OF LOBBYIST (Last) (First) (Middle Name) Design Tech International Associates, Inc. 14125 NW 80th Avenue, Suite 303, Miami Lakes, FL 33016 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) (786)235-9097 x 204 (305)431-3098 ccardoso@dtiarchitect.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Seibane Rochelle NAME OF PRINCIPAL (Last) (First) (Middle Name) Ministerio Internacional Fl Rey Jesus 730 77 Street Miami Reach FL 33747 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 786-877-9790 c/o SandyPineda@ElReyJesus.org PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS •5 Section'2-482(h)(1 a o i le-I Oft,corporation;partnership,CI?? j •e a e 7 a lobbyist CIE behalf (li :MR%p without special compensation CQ reimbursement for89 appearance:04MT direct, indirect,CQ.contingent,RD da'agagsue•art acFo••osition t• 3y113 1EEdnapida the @O&M re.uired,(,., J subsection INasal= re•uireda)(• 0HTre•istrationf If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2-482(c): • NAME OF CHIEF OFFICER, PARTNER,OR BENEFICIARY(if none,write N/A): Rachelle Seibane, COO • 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): See attached. Page 1 of 5 Cr� 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. Development approvals and permitting issues, including, but not limited to the Historic Preservation Board, Design Review Board, Planning Board, Board of Adjustment, Land Use and Sustainability Committee, City Commission, any City Workshops or Committees, and City Departments, if necessary relating to the property located at 730 71 Street, Miami Beach, Florida. 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 Staff for the Planning Department, Building Department None. X Public Works, and City Afministration, PB, HPB, BOA None. X DRB, City Commission, and Mayor as necessary None. X 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): None. None. 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): $150.00 per hour Page 2 of 5 The following six(6)questions MUST be answered: 1) Pursuant to City Code Section 2-488, entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": _Yes XNo: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or pending award for goods,equipment or service? 2) Pursuant to City Code Section 2-490, entitled "Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": —Yes XNo: Are 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 City's Future Land Use Map? 3) Pursuant to City Code Section 2-482(h), any person (except those exempt from the definition of "lobbyist" as set forth in Section 2-481) 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: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement? 4) Pursuant to City Code Section 2-481, the term "lobbyist" specifically excludes the following persons: 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 far 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 or representing a not-for-profit based organization for the purpose of requesting a grant without special compensation or reimbursement? 5) Pursuant to City Code Section 2-491(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 2-491 for more information. —Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes, please list the incumbent member(s)of the City Commission: ,° t4*� ar . °i142 _Yes_No: If,��>:ves; i as it beeenn lessthan la monthsi,sincee th ected bofficial(s) whom-you provided campaign consulting services wassworn intl 6) Pursuant to City Code Section 2-482(a)(4)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 lobbying the City Commission at a public meeting. —Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes, please list the incumbent member(s)of the City Commission: —Yes_No: If es, were v°o rrrpromrsed(o'r didlyodrrea ve economiic consideration tin for campaign c o ns u iti n g serui c es91 TO BE COMPLETED BY CITY CLERK'S STAFF ONLY p Annual Registration fee:"`[ ]Yes[ ]No Amount Paid$ �` � � -MCR# L' �`"�`9 Date Paid - �%' Lobbyist Registration Form received and verified by: —`> ) F:\CLER\$ALL\aFORMS\LOBBYIST FOR IS\Lobbyist Registration Form Revised 09-.20-18 REG.doc Revised 09/20/2018 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, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPENSATION DURING THE REPORTING PERIOD.1 Signature of Lobbyist: Date 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 the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Code and all reporting requirements. Signature of Lobbyist: Date ), Signature of Principal: Date 4- D_ ---aoa0 VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL A State of State of 'QI(1 t © u k • County of: County of: \I pt1 — 1 d• Sworn to (or affirmed) and subscribed before me, Sworn to (or affirmed) and subscribed before me, by means of 0 physical presence by means of physical presence or 0 online notarization, or 0 online notarization, this day of 20 29 by this-tS day of _Aft 1 , 2020 by Carlos G. Cardoso Rachelle Seibane ` NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION _Personally Known NP s nally Known , I Signature of Notary Public Sig a `e o/Nir:=ry P blit ?OfIVIthvv! Name of Notary, Typed, Printed or Stamped Narrr d` kakiryl, I , Printed or Stamped 5 ION '•q '��ii (NOTARY SEAL) (vuTA� °ip:.• .� 1 N =* ®.r •fit — 1 The term"lobbyist"specifically excludes the following persons: y••7 6 087061 h• :Q Q • ? Expert witnesses who provide only scientific,technical or other specializecr9rm'aUonrdf'**wen public meetings;any person who only appears as a representative of a neighborhood association without corligs9 ration a! K ibment for the appearance, whether direct, indirect or contingent, to express support of or opposition to any item; arrd'any.peSso t ho 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 • 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, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGA i 0 LOBB . = STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR COMPE' ATION DURING TH NG PERIOD.1 Signature.of Lobbyist: Date CA: 2 = Y 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 -- 'iar with the • .visio s con :fined in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City Co•,e and all reporting req irem-* s. - Ai\ 5.-A/ Signature of Lobbyist: --Nom.- Date 24) Signature of Principal: Date VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: �� PRINCIPAL -State of P -C-N' State of County of: 1 ll4YfI County of: Sworn to(or a�ffir9d)and subscribed before me, Sworn to (or affirmed)and subscribed before me, by means of LR'physical presence by means of 0 physical presence or 0 online notarization notarizatimp or 0 online notarization, this ba day of i LAI , 20 29 by this_day of ,202g by Carlos G. Cardoso Rachelle Seibane NAME OF LOBBYIST NAME OF PRINCIPAL _Produced ID _Produced ID FORM OF IDENTIFICATION FORM OF IDENTIFICATION Personall own _Personally Known i.n.ture two ary PublicSignature of Notary Public s EANC-3 Name of NotwasmArealolillimbasIbesaisoopaiiiho Name of Notary, Typed, Printed or Stamped I 4,16e•., JACKELINE TORRES NOTARY SI! � Notary Dubllc State of Florida NOTARY SEAL) ( Commission:GG 9o; ( � 'ov My Comm.Expires Dec 12,2023 I "'Bonded through National Notary Assn. I 1 The term"lobbyist"specifically excludes the following persons: 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 MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E.Granado,City Clerk CityClerk@miamibeachfl.gov Tel:305.673.7411,Fax:305.673.7254 NAME OF LOBBYIST: Carlos G. Cardoso 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 Octo•- 1 of each year, and the fee for such annual registration shall be $500.00 uant to Secti• - of the Miami Beach City Code. `gift CAfr (..) Signore of Lobbyist Date F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\Lobbyist Registration Form Revised 09-20-18 REG.doc Page 5 of 5 I fa ms Department of the Treasury IJ Internal Revenue Service P.O. Box 2508, Room 4010 In reply refer to: 4077556534 Cincinnati 0H 45201 Apr. 28, 2011 LTR 4168C C3 65-0605906 000000 00 X 00036000 BODC: TE MINISTERIO INTERNACIONAL EL REY JESUS INC PHILIP S HANEY ASSOCIATES X PHILIP S HANEY 1437 SOUTH BOULDER STE 1050 TULSA OK 74119-3616 027204 Employer Identification Number: 65-06.05906 Person to Contact: SHARON LENARD Toll Free Tig-ieptro"ne -Number":--1-877•-5-29"•-550-0- - _ .. Dear Taxpayer ; This is in response to your Sep. 22, 2010, request for information regarding ,your tax-exempt status. Our records indicate that you were recognized as exempt under section 501 (c) (3) of the Internal Revenue Code in a determination letter issued in August 1996. Our records also indicate that you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(s) 509(a) (1) and 170(b) (1) (A) (i) . Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Please refer to our website www.irs.gov/eo for information regarding filing requirements. Specifically, section 6033(j) of the Code provides that failure to file an annual information return for three consecutive years results in revocation of tax-exempt status as of the filing due date of the third return for organizations required to file. We will publish a list of organizations whose tax-exempt status was revoked under section 6033(j) of the Code on our website beginning in early 2011. • 4077556534 Apr. 28, 2011 LTR 4168C C3 65-0605906 000000 00 X 00036001 MINISTERIO INTERNACIONAL EL REY JESUS INC PHILIP S HANEY ASSOCIATES X PHILIP S HANEY 1437 SOUTH BOULDER STE 1050 TULSA OK 74119-3616 If. you have any questions, please call us at the telephone number shown in the heading of this latter. Sincerely yours, 644 TiAIMV/A-1 Cindy Thomas Manager, Eo Determinations Slate of Florida Department of State I certify from the records of this office that MINISTERIO INTERNACIONAL EL REY JESUS, INC. is a corporation organized under the laws of the State of Florida, filed on June 23, 1995. The document number of this corporation is N95000003016. I further certify that said corporation has paid all fees due this office through December 31, 2018, that its most recent annual report/uniform business report was filed on September 7, 2018, and that its status is active. I further certify that said corporation has not filed Articles of Dissolution. Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Third day of December, 2018 y 1U;4�t ` r,,`tom.: ''fit•'r'• 1 7P it ,-.77�...- -I .. 1("AN 1)4 i4°‘ �'": %- Secretary of State Tracking Number:CU1110732468 To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateOfstatus/CertificateAuth entication 2020 FLORIDA NOT FOR PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT#N95000003016 Apr 08, 2020 Entity Name: MINISTERIO INTERNACIONAL EL REY JESUS, INC. Secretary of State 8314781601 CC Current Principal Place of Business: 14100 SW 144TH AVENUE MIAMI, FL 33186 Current Mailing Address: 14100 SW 144TH AVENUE MIAMI, FL 33186 US FEI Number: 65-0605906 Certificate of Status Desired: Yes Name and Address of Current Registered Agent: SEIBANE,RACHELLE 14100 SW 144TH AVENUE MIAMI,FL 33186 US The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both,in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date Officer/Director Detail : Title PD Title SD Name MALDONADO,GUILLERMO Name LAFFITTE,JOHN Address 14100 SW 144TH AVENUE Address 8421 SW 202 STREET City-State-Zip: MIAMI FL 33186 City-State-Zip: MIAMI FL 33189 Title D Title COO Name HECHAVARRIA,FRANK Name SEIBANE,RACHELLE Address 14100 SW 144TH AVENUE Address 14100 SW 144TH AVENUE City-State-Zip: MIAMI FL 33186 City-State-Zip: MIAMI FL 33186 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that i am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617,Florida Statutes;and that my name appears above,or on an attachment with all other like empowered. SIGNATURE:RACHELLE SEIBANE COO 04/08/2020 Electronic Signature of Signing Officer/Director Detail Date Miscellaneous Cash Recei t CITY of MIAMI BEACH ; =No.4426646 D^Cash .,p Credit Card ?Check# ; ' 2Q71 F . ce)glneous .M E x" 024 ,i,,,‘-'"2-,.'.,,r'''''2;22.-1:., 112,, ` : t '7-4017 M tri A ° 1 U u s B a a ti z �� 1 TIZ71lilLU T a l 'fii,: F CR OPENn.(McR i -., , -- ., g° _h, r , Y a Payment ,m unt 1,2007 04 7 ` • \ S (THIS INFORMATION MUST BE,,COMPLETED) �Office of Finance Director ; �_ Bye Account:Humber. . . . t I ., , -'' � 5 De▪t: EXT: t ; { Prepares �" � �,� � � p if qM Ta -'Z':', .f \ ? ¢ s a M .,,,--....":::,..,:„1::::,.,,,,,,,:::'''':1-''' x :,:f.,„;:,,,'`,,,‘'.1,7',:',','-','„:;:‘,,,,‘- "� .�.�� :Lia f4<r, T w eta ....x_ ,, , . '�3,%...._...._.• ` ""°� i ...,�. i � ire