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Miles Copeland/ Firstars, Inc. . RECE\VED 03 NO~ \ 1 PM 2: 42 CITY CLERK'S Off ICE .' City of Miami Beach Office of the City Clerk 1700 Convention Center Drive, Miami Beach, Fl 33139 Email: cityclerk@d.miami-beach.fI.us LOBBYIST REGISTRATION FORM (City of Miami Beach, City Code Chapter 2, Division 3, Section 2-481) 1:1 Check Box if an Amendment TELEPHONE NUMBER: mILGS' (First) (M.I) DATE QUALIFIED AS lOBBYIST PfPrUO~e S~ OAKr CA- 9/403 (State) (Zip Code) ~De~ Iflt/es. Cop~JQrd 0>~~2/. CD,.,.. EMAll: C OPfLANP NAME OF lOBBYIST: (last) jj7M. VVlfu((A Bl,v'p BUSINESS ADDRESS: (Number and Street) (City) 32s 51l. 4Oceo ~2J ~/2- FAX NUMBER: I. 6;;;mRi~:BY: NAME OF PRINOPAljCLlENT: V RJrfufa ~ $"{ 2- lEPHONE NUMBER: /47 e~VD ~1If/lJ't (Number and Street) (City) '3~3 ~Jl<<mAtJ OAJcr C q/L}::>J (State)!ll/!e.r. ~codela eV/kK.ZI, ~ EMAIl: (0 tional) Dee> Fill out this section if prindpalls a Corporation, Partnership or Trust [Section 2-482 (e)] . NAME OF CHIEF OFFICER, PARTNER, OR BENEFICIARY: m/t4S COPbtA1Vc> LIST ALL PERSONS HOLDING, DIRECTLY OR INDIRECTLY, A S% OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION, PARTNERSHIP OR TRUST: /nIL'S CoP'LAND U. SPEaFle LOBBY ISSUE: GfA-N-r reo/^. IYlta/Yl1 ~c.h VGA ~e {1/bI}- CtJ- tfllOfJIl f<~ch G1/"~II+fO/"\ C~ Issue to be lobbied (Describe in detail): m. CI1Y AGENOES/INDMDUALS TO BE LOBBIED: A) Full Name of Individual/Title B) Relationship ,,~-h(Jl1 .I.v. U.I.~L.Uo:tUKC ur . CKPI" ftnU IU"'IUurt.., ur LUDDI' .I.". \",U.......cn~..I.un \U.a.;:M...LU.,C "'"1:. ncl'\ nUUKL. r, FLAT RATE OR OTHER): f. ott't1J11t(J] /10 I kctl'J"J GI1'IJ>.e/lSqfID..... , A) LOBBYIST DISCLOSURE: . B) PRINCIPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION): /VIA 1) Pursuant to Ordinance No. 2003-3393 Amendina Miami Beach City Code Chaoter 2. Article VII. Division S Thereof Entitled "Cam~aian Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited Camoaian Contributions Bv Lobbvists On Procurement Issues": 2) ? V. SIGNATURE UNDER OATH: ON OCTOBER lSf OF EACH YEAR, EACH LOBBYIST SHALL SUBMrr TO THE CITY CLERK A SIGNED STATEMENT UNDER OATH, USTlNG LOBBYING EXPENDrrURES 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 contained i ection 2- Miami Beach City Code as amended, and all reporting requirements. Signature of Lobbyist: Signature of Principal/Client: VI. LOBBYIST IDEN1lFICATION: J4.. Produced lD n i>~vaJ., C((:.e;~~tf Form of Idlntification ZORICK PARSANIAN Commission # 1383523 Notary Public, California ~ Los Angeles County - My Comm. Expires Nov 5. 2006 ~ CJ 0 -i W ?J -< :z: n 0 rn r .c:: (') rn :::0 -.l rn ';':: ,- cr> " < ::J: 0 ~ rn -., 0 -n .:;:- CJ N lT1 Personally Known vn. SIGNATURE AND STAMP qF NOTARY OR DEPI11Y CLERK: CAUPPfljJ',4 t..~ AN6.6~ State of rlorida', County of ~1iaFfli Dade Sworn to nd subscribed before me This 'fI1 da of /JJJt/. , 2003. Sig ture of Public Notary State of flu I idd .d CA-{.J~I'"rT ~ra< /1wtSMIAft.,( Print, stamp or type name of Notary Public Registration: ~PTED If rejected, state reason: /' Registration fee paid: ['1Yes [ ] No DATA ENTRY DATE: 4 7. / \ 2nd Revision 3/18/03 . FOR CLERK'S USE ONLY [ ] REJEcrED DATE: ./ [ ] Cash [l,9led< MCR . 2003 ENTERED BY: ~\Lobbyists\registrationa03.doc