Lauren Weiner/Art Basel
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Oty of Miami Beach Office of the City Oerk
1700 Convention Center Drive, Miami Beach, FL 33139
Email: cityderk@d.miami-beach.fl.us
LOBBYIST REGISTRATION FORM
RECE\VEO
03 NO\l24 AM \0: \ 3
cITY CLERK'S Off ICE
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(Oty of Miami Beach, City Code Chapter 2, Division 3, Section 2-481)
[J Check Box if an Amendment
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NAME OF LOBBYI : (Last) (First) (MJ) DATE QUAUFIED AS LOBBYIST
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BUSINESS ADDRESS: (Number and Street) , (City) (State)' (Zip Code)
78& .2S3.322C::;- 305 .(pd4- .crt73 LttVetne>Rarihc<s.f?(,(O(1-
TELEPHONE NUMBER: FAX NUMBER: EMAIL:
I. LOBBYIST RETAINED BY:
1Ir-l- I3t1Ys-e I Ih/~U'h/ &a:Ch
NAME OF PRINOPAl/QlENT:
31'7./~IJLI. 0737
TELEPHONE NUMBER:
mlam" /Yael, 1Ft 33/31
(State) . (Zip Code)
305 .&o4-.&Jq7~
FAX NUMBER: (Optional)
3/ / L/n coin 1!d. Su/ k 3/0
BUSINESS ADDRESS: (Number and Street)
(City)
.--
EMAIL: (Optional)
Fill out this section if prindpal is a Corporation, Partnership or Trust [Section 2-482 (e)]
. NAME OF CHIEF OFFICER, PARTNER, OR BENEFIaARY:
UST ALl PERSONS HOLDING, DIRECTlY OR INDIRECTlY, A S% OR MORE OWNERSHIP INTEREST IN SUOi
CORPORATION, PARlNERSHIP OR TRUST:
n. SPECIFIC LOBBY ISSUE:
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Issue to be lobbied (Describe in detail):
m. CITY AGENCIES/INDMDUALS TO BE LOBBIED:
A) Full Name of Individual/Title
B) Relationship
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1.Y. U.I.;:K..LU:KJtU: ur I CKPI:IIArtu "....UU....;:) ur LVDDI .1.;:)1 ....VM~CI'C:N\I.lV... \UJ.:::M....LV:JC nncl ncn. nVVf(L',
FLA T RATE OR OTHER):
A) LOBBYIST DlSCLOSIlRE:
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B) PRINQPAL'S DISCLOSURE (OF LOBBYIST COMPENSATION):
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1) Pursuant to Ordinance No. 2003-3393 Amendinq Miami Beach Citv Code Chaoter 2. Article VII. Division 5
Thereof Entitled "Camoaiqn Finance Reform" Via The Addition Of Code Section 2-488 Entitled "Prohibited
Camoaiqn Contributions Bv Lobbvists On Procurement Issues":
nt or services or on a resent
2) Pursuant to Ordinance No. 2003-3395 Amendinq Miami Beach Citv Code Chaoter 2. Article VII Division 5
thereof Entitled "Camoaiqn Finance Reform", Via The Addition Of Code Section 2-490 Entitled "Prohibited
Camoaiqn Contributions Bv Lobbvists On Real Estate Develooment Issues":
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V. SIGNATURE UNDER OATH:
ON OCTOBER 1ST OF EACH YEAR, EACH LOBBYIST SHALL SUBMIT TO THE CITY CLERK A SIGNED
STATEMENT UNDER OATH, USTING 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 contained in Section 2-482 of the Miami Beach City Code as amended, and all
reporting requirements. ~
Signature of Lobbyist:
Signature of Principal/Client:
VI. LOBBYIST IDENTIFICATION:
Q Produced ID J')r '\ ve..tS I j elf' X)Le..
Form of lrentification
Personally Known
VII. SIGNATURE AND STAMP OF NOTARY OR DEPUTY CLERK:
State of Florida, County of Miami-Dade
Sworn to and sUbscri~ ~fore me
This ..ati.--day of [)\J. . 2003.
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Signature of Public Notary - State of Florida
",'j::"~ Marma Blueslone
Print, stam;M;;~=:;t;;;PUbliC
FOR CLERK'S USE ONLY
Registration: .K:[ ACCEPTED
If rejected, state reason:
Registration fee paid: ~es, [,] No [ ] Cash ~ MCR
DATA ENTRY DATE: ~ 2003 ENTERED BY:
2nd Revision 3/18/03
[ ] REJECTED
DATE:
_{l~Q..Lf-03
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HAll.\Lobbyists\registrationa03.doc