Deborah L. Martohue FY 22_23 AnnualCity of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
www.mianiibeachfi.gov
City Clerks Office
Tel: 305-673-7411
Fax: 305-673-7254
RECEIVED
JAN -6 2023
CITY OF MIAMI BEACH
OFFICE OF THE CITY CLERK
Office Use Only
ANNUAL LOBBYIST REGISTRATION FORM
Name:
Business Name: `{
Address: 10,3160
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Office Telephone Number:
Cellular Telephone Number:
Email Address: c—z)
If more than one lobbyist, please list:
1)
2)
3)
4)
5)
7)
1
10 14
Submit this form to the Office of the City Clerk, along with a check for $500 for each
lobbyist. Please make the check(s) payable to the City of Miami Beach.
For City Clerk's Office Use Only
MCR #:�YIcA?_ RECEIVED
Amount paid: 500 e 00 Date paid: JAN —6 2023
Processed by:L(,cm( A- Date: CITY OF MIAMI BEE nru
OFFICE OF THE CITY CLERK
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